Question

A 40-year-old man, who was the unrestrained driver of a car that hit a tree at a high rate of speed, struck the steering wheel with his chest. He has a large bruise over the sternum and an irregular pulse rate of 120 beats/min. You should be MOST concerned that he:

A. has injured his myocardium.
B. has a collapsed lung and severe hypoxia.
C. has extensive bleeding into the pericardial sac.
D. is at extremely high risk for ventricular fibrillation.

Answer 1

The most immediate concern for the patient is a potential injury to the myocardium due to direct chest trauma and the presence of an irregular pulse rate.

Step-by-step explanation:

In the scenario presented, the most immediate concern for the 40-year-old man, who has suffered a high-impact chest trauma, is that he has injured his myocardium (A). The irregular pulse rate and high speed of the collision indicate potential damage to the heart's muscular tissue, which could lead to complications such as cardiac contusion or even a myocardial infarction (heart attack). While other injuries such as a collapsed lung (B), bleeding in the pericardial sac (C), and the risk for ventricular fibrillation (D) are also possible concerns, the myocardial injury needs to be evaluated urgently due to the direct trauma to the chest and the abnormal heart rhythm.