Echocardiographic evaluation after blunt trauma of the chest

Markiewicz, Walter; Best, Lael‐Anson; Burstein, Shimon; Peleg, H

doi:10.1016/0167-5273(85)90218-9

Cited by 21 publications

(4 citation statements)

References 13 publications

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“…[17,18] ECHO findings were normal in 65% (n=65) of cases, while abnormal ECHO findings were revealed in 31% (n=31) in the present series. The most common finding was ventricular wall motion abnormality as detected in 20% of cases.…”

mentioning

confidence: 67%

The Relationship of Trauma Severity and Mortality with Cardiac Enzymes and Cytokines at Multiple Trauma Patients

Karakuş

Kekeç²,

Akçan³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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mentioning

confidence: 67%

The Relationship of Trauma Severity and Mortality with Cardiac Enzymes and Cytokines at Multiple Trauma Patients

Karakuş

Kekeç²,

Akçan³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…showed a concordance between important cardiac complications and abnormal ECG findings [16] . Previous studies report a high likelihood of abnormal FAST results, ECG findings, and myocardial markers in patients with cardiac injuries secondary to chest trauma [17,18] .…”

Section: Discussionmentioning

confidence: 98%

Severe cardiac trauma or myocardial ischemia? Pitfalls of polytrauma treatment in patients with ST-elevation after blunt chest trauma

Özkurtul

Höch

Reske

et al. 2015

Annals of Medicine &Amp; Surgery

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IntroductionThoracic injuries are the third most common injuries in polytrauma patients. The mechanism of injury and the clinical presentation are crucially important for adequate emergency treatment.Presentation of caseHere we present a case of a 37-year-old male who was admitted to our level-1 trauma center after motor vehicle accident. The emergency physician on scene presented the patient with a myocardial infarction. During initial clinical trauma assessment the patient developed circulatory insufficiency so that cardiopulmonary resuscitation was necessary. Considering the preclinical and clinical course it was decided to proceed with thrombolysis. Despite consistently sufficient resuscitation measures circulatory function was not restored and the patient remained in asystole and passed away.DiscussionThe initial assessment showed cardiopulmonary instability. After applying thrombolysis a therapeutic point of no return was reached because surgical intervention was impossible but autopsy findings showed severe myocardial and pulmonary contusions likely due to shear forces.ConclusionThis case outlines the importance of understanding the key mechanism of injury and the importance of communication at each stage of healthcare transfer. A transesophageal echocardiography can help to identify injuries after myocardial contusion.

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“…In one study, 87% of patients with BCI had wall motion abnormalities [17]. Unfortunately, ECHO may be difficult to perform in the acute setting because of chest wall tenderness, inability to position the patient optimally, and the presence of pneumothorax or hemothorax, resulting in a poor quality study [18,19]. For this reason it should be considered a complementary, not a definitive, test [20].…”

Section: Discussionmentioning

confidence: 99%

Determining Which Patients Require Evaluation for Blunt Cardiac Injury following Blunt Chest Trauma

et al. 2001

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The objective of this study was to determine prospectively which risk factors require cardiac monitoring for blunt cardiac injury (BCI) following blunt chest trauma. All patients who sustained blunt chest trauma had an electrocardiogram (ECG) on admission to our urban level I trauma center. Those with ST segment changes, dysrhythmias, hemodynamic instability, history of cardiac disease, age > 55 years, or a need for general anesthesia within 24 hours (group 1) were admitted to the intensive care unit (ICU) for 24 hours where they were subjected to serial ECGs, creatinine phosphokinase (CPK) assays, and echocardiography (ECHO). Those with only mechanism for BCI, i.e., none of the above risk factors (group 2), were admitted to a nonmonitored bed and had a follow-up ECG 24 hours later. A series of 315 patients were admitted with blunt chest trauma during a 17-month period; 144 patients were in group 1 and 171 in group 2. Overall, 22 patients were diagnosed as BCI (+BCI), defined as evolving ST segment changes, dysrhythmias, a CPK-MB index of > 2.5, or hemodynamic instability. Of the 18 +BCI patients in group 1, all were symptomatic (i.e., none was included solely for a cardiac history, age, or need for general anesthesia). Six of these patients required treatment for dysrhythmias, hypotension, or pulmonary edema; one of whom died. Four patients with +BCI were in group 2 and had ECG changes at 24 hours; none of these four had any sequelae from their +BCI. None of the ECHOs demonstrated abnormal wall motion. Patients who sustain blunt chest trauma with a normal ECG, normal blood pressure, and no dysrhythmias on admission require no further intervention for BCI. Patients with ST segment changes, dysrhythmias, or hypotension following blunt chest trauma should be monitored for 24 hours, as this subgroup occasionally requires further treatment for complications of BCI. ECHO adds nothing as a screening test.

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Echocardiographic evaluation after blunt trauma of the chest

Cited by 21 publications

References 13 publications

The Relationship of Trauma Severity and Mortality with Cardiac Enzymes and Cytokines at Multiple Trauma Patients

The Relationship of Trauma Severity and Mortality with Cardiac Enzymes and Cytokines at Multiple Trauma Patients

Severe cardiac trauma or myocardial ischemia? Pitfalls of polytrauma treatment in patients with ST-elevation after blunt chest trauma

Determining Which Patients Require Evaluation for Blunt Cardiac Injury following Blunt Chest Trauma

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