• Williams JC
• Elkington WC

• Contusions / physiopathology
• Heart Injuries
• Wounds and Injuries
• Wounds and Injuries / complications
• Wounds, Nonpenetrating

Clinical Features: A 51-year-old man was in a motor vehicle accident. After the collision, he noticed a slow onset of chest discomfort with exertion and bradycardia. The patient experienced cardiac difficulty during a stress electrocardiogram. During the 4 months after the motor vehicle accident, symptoms progressed; and a diagnosis of vagal sympathetic reflex was suggested.

Intervention and Outcome: A pacemaker was finally required because of the ventricular pacing of 35 to 40 beats per minute, which was symptomatic of a complete atrioventricular block.

Conclusion: A gradual progression to complete atrioventricular block over a period longer than 3 weeks is unusual. This case demonstrates that a patient manifesting exertional bradycardia and shortness of breath shortly after chest trauma should be regularly monitored until all symptoms are resolved.

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