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PURPOSE: Traumatic asphyxia is a rare clinical syndrome characterized by cervicofacial cyanosis, edema, and multiple petechiae after a severe chest crush injury, and ophthalmic involvement includes violaceous discoloration of lid, lid edema, bulbar subconjunctival hemorrhage, exophthalmos and retinal hemorrhage. The authors experienced a case of traumatic asphyxia with typical ophthalmic manifestations after a crush chest injury, and we report this case with literature review. METHODS: A-54-year old man was consulted for bilateral proptosis after a crush chest injury. Ophthal-mologice valuation and intervention were performed. RESULT: Right eye was not checked due to previous corneal opacity, but visual acuity was 0.8 and IOP was 45 mmHg in left eye. There were bilateral proptosis and severe bulbar subconjunctival hemorrhage, and orbital computed tomography showed orbit fat interposed between globe and medial orbital wall. IOP was controlled with medications and other clinical signs including proptosis showed progressive improvement.
Asphyxia* ; Corneal Opacity ; Cyanosis ; Edema ; Exophthalmos ; Hemorrhage ; Orbit ; Purpura ; Retinal Hemorrhage ; Thoracic Injuries ; Thorax ; Visual Acuity

3.Relation between the Efficacy of Amiodarone on Chronic Atrial Fibrillation and Left Atrial Size and Fibrillatory Wave Form.

Young Kyu HONG ; Hong Seog SEO ; Dong Joo OH ; Young Moo RO

Korean Circulation Journal 1989;19(1):125-131

To assess the efficacy of amiodarone on chronic atral fibrillation(AF) and to evaluate the relation between the ability to convert AF to sinus rhythm (SR) with amiodarone therapy and left atrial(LA) size and atrial fibrillatory wave forms, 22 patients with AF, aged 40 to 60 years(mean 47.5 years), were studied. Nine patients(40.9%) had mitral valvaular heart disease, 6(27.3%) hypertension, 5(18.2%) lone AF and 2 (9.1%) cadiomyopathy. Amiodarone therapy with either 600mg for 1 week, 200mg for 4 weeks in 5 consecutive patients, or 800mg for 1 week, 400mg for 4 weeks and 200mg for 6 weeks in 17 patients, converted AF to SR in 9(40.9%) patients 3 to 6 weeks after amiodarone was started on. In either group, patients who achieved conversion had smaller LA size(mean 43.7mm) than those who failed conversion(mean50.2mm)(P<0.05). Those who had LA size less than 45mm achieved conversion of AF to SR in 70%, comparing to 16.7% in patients with LA size more than 46mm(P<0.05). Among patients who achieved conversion, LA size was less than 46mm in 77.8% comparing to 23.1% in patients who failed conversion on Amiodarone. Those with coarse AF(46.2mm), althogh the difference was not significant statistically. There was no converstion in patients with LA size greater then 58mm and in patients with coarse AF who concomittantly had MVD. These findings suggest that the efficacy of amiodarone was related to LA size, and to the atrial fibrillation wave form in patients with mitral valvular heart disease.
Amiodarone* ; Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension