Elevated Cardiac Troponin I Level in Cases of Thoracic Nonaccidental Trauma

Bennett, Berkeley L.; Mahabee-Gittens, Melinda; Chua, Michael S.; Hirsch, Russel

doi:10.1097/pec.0b013e3182307afe

Cited by 17 publications

(4 citation statements)

References 17 publications

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“…There have been few reports of cardiac injuries due to child abuse . Previously reported abusive cardiac injuries include commotio cordis , tears of the great vessels or atria , traumatic septal defects , atrial intimal tears, intra‐cardiac thrombi , elevated cardiac enzymes , penetrating trauma , contusions and aneurysms , subsequent perforations through previously damaged myocardium and hemopericardium . Cohle reported the one case of left ventricular perforation and 5 atrial injuries due to abusive blunt impact .…”

mentioning

confidence: 99%

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Yarid

Brown

Boos

et al. 2018

Journal of Forensic Sciences

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Traumatic cardiac ventricular ruptures in children are rare. Only a single case of left ventricular rupture due to child abuse has been reported. We report a child who sustained a fatal left ventricular apical rupture. It appeared to have resulted from hydrostatic forces resulting from abusive blunt thoracic injury. That he was being abused was previously missed when he was presented to the emergency department with facial pyoderma. It was not noted that he also had lip and oral mucosal injury, sites not affected by staph toxins. As a result, his underlying, abusive and secondarily infected, facial flow type scald burn was not appreciated. Within a week thereafter his fatal injury occurred, accompanied by extensive and obvious associated abusive injuries. Postmortem high-detail whole body computed tomography scanning aided the autopsy. Although rare, ventricular rupture from abusive blunt thoracic injury can occur.

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mentioning

confidence: 99%

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Yarid

Brown

Boos

et al. 2018

Journal of Forensic Sciences

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“…1 Troponin I levels may help assess for blunt cardiac injury in children with suspected CPA. 19 Risk factors that may suggest a benefit to obtaining a troponin I level include age older than 3 months (to avoid a physiologic elevation), abdominal injury, rib fracture, and ill appearance. 20…”

Section: Laboratory Evaluationmentioning

confidence: 99%

Child physical abuse trauma evaluation and management: A Western Trauma Association and Pediatric Trauma Society critical decisions algorithm

Rosen

Escobar

Brown

et al. 2021

J Trauma Acute Care Surg

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“…Ancak çocukluk çağında göğüs ağrılarının nedeni nadiren kardiyak nedenler ile ilşkilidir ve bu hastaların neredeyse tamamında troponin düzeyleri normaldir (4). Bununla birlikte çok farklı etyolojik nedenlerle çocuklarda myokard hasarı gelişebilir ve troponin düzeyleri yükselebilir (5,6,7). Bir hastada troponin düzeylerinin yüksek saptanması ister erişkin ister çocuk hasta olsun hekimi oldukça tedirgin eden bir durumdur.…”

Section: Introductionunclassified

Cocuklarda Troponin Yuksekliginin Nedenleri ve Yardimci Tanisal Degerlendirmeler

2018

GMJ

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ÖZETAmaç: Bu çalışmada çocukluk çağında troponin yüksekliğinin nedenlerinin ve yardımcı tanısal değerlendirmelerin belirlenmesi amaçlanmıştır. Metod: Ocak 2014-Ocak 2017 tarihleri arasında Adnan Menderes Üniveristesi hastanesinde 0-18 yaş arasında troponin düzeyleri yüksek saptanan çocuk hastalar çalışmaya dahil edildi. Retrospektif olarak dosyaları incelendi. Hastaların başvuru yaş, cinsiyet,ağırlık, boy bilgileri ile birlikte yakınmaları, başvuru şekli, yapılan tanısal değerlendirme yöntemleri gözden geçirildi. Troponin yüksekliğine neden olan tanıları belirlendi. Bulgular: 24'ü kız, 31'i erkek toplam 55 çocuk hasta değerlendirildi. Hastaların en sık acil servise başvurduğu belirlendi. Hastaların büyük çoğunluğunun asemptomatik olduğu ancak en sık saptanan kardiyak semptomun göğüs ağrısı olduğu belirlendi. Hastaların genellikle bilinç değişikliği, kusma, böcek sokması gibi kardiyak yakınmalardan farklı nedenlerle merkezimize başvurduğu belirlendi. Troponin yüksekliğinin en sık sebepleri; 19 hastada (%34.5) CO intoksikasyonu, 17 hastada (%30.9) akrep sokması ve 6 hastada(%11) myokardit olarak belirlendi. Hastalarda tanıya en çok yardımcı olan değerlendirme yönteminin %25.5 hastada patolojik bulgu saptanmasını sağlayarak, elektrokardiyografi (EKG) olduğu görüldü. Koroner anjıografinin sadece 3 hastaya yapılmış olduğu ve sonuçların normal olduğu belirlendi. Sonuç: Çocukluk çağında troponin yüksekliğine en sık sebep olan nedenler toksik ve enflamatuar myokard hasaradır. Tanıya en çok yardımcı olan değerlendirme yöntemi EKG'dir. Koroner anjıografi ancak seçilmiş bir hasta gurubuna uygulanmalıdır. ABSTRACT Aim: The aim of this study was to determine the causes of troponin elevation and adjunctive diagnostic evaluations in childhood. Methods: Aged 0-18 years pediatric patients diagnosed with troponin elevation in the Adnan Menderes University hospital between January 2014 and January 2017 were included in the study. Retrospectively reviewed the files. Patients' ages, gender, weight, height information, complaints, application form, diagnostic evaluation methods were reviewed. The diagnoses that led to the elevation of troponin were identified. Results: A total of 55 children (24 girls, 31 boys) were evaluated. It was determined that the patients were most frequently had emergency services. Majority of the patients were asymptomatic but the most frequent cardiac symptom was chest pain. Patients were usually referred to our center for different reasons from cardiac complaints such as consciousness alteration, vomiting, insect insertion. The most common causes of troponin elevation are; CO intoxication in 19 patients (34.5%), scorpion insertion in 17 patients (30.9%) and myocarditis in 6 patients (11%). Electrocardiography (ECG) was found to be the most helpful diagnostic method in patients by providing had 25.5% pathologic findings. It was determined that coronary angiography was performed in only 3 patients and the results were normal. Conclusion:The most common causes of troponin elevation in childhood are toxic and ...

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Elevated Cardiac Troponin I Level in Cases of Thoracic Nonaccidental Trauma

Cited by 17 publications

References 17 publications

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Child physical abuse trauma evaluation and management: A Western Trauma Association and Pediatric Trauma Society critical decisions algorithm

Cocuklarda Troponin Yuksekliginin Nedenleri ve Yardimci Tanisal Degerlendirmeler

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