Left Cardiac Luxation Caused by a Blunt Chest Trauma: A Difficult Diagnosis Confirmed on Chest Computed Tomography Scan—Two Case Reports

Quintard, Hervé; Badia, Emmanuelle; Duponq, Raphaëlle; Samat-Long, Corine; Vénissac, Nicolas; Ichaï, Carole

doi:10.1097/ta.0b013e318166d2a9

Cited by 1 publication

(3 citation statements)

References 16 publications

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“…This sudden onset coupled with the rarity of this presentation often results in cardiac herniation being missed until the patient becomes severely symptomatic or hemodynamically unstable. Other signs that indicate cardiac herniation include intermittent loss of pulse, maximum heart sounds in abnormal locations, and resolution of symptoms with a change of position ( 8 , 10 , 21 , 55 , 60 , 61 ).…”

Section: Types Of Blunt Cardiac Traumamentioning

confidence: 99%

“…They have also been utilized in the evaluation of cardiac trauma as both can be increased as a result of injury to the heart. CK is often released from skeletal muscle as well and so is less specific for cardiac damage, especially in the context of multi-system trauma as is often seen with BCT ( 3 , 8 , 18 , 21 , 30 ).…”

Section: Evaluation and Treatments Of Blunt Cardiac Traumamentioning

confidence: 99%

“…Coronary injury may also be evaluated with laboratory tests such as the cardiac enzymes CK and troponin. Since troponin is elevated with other cardiac injuries such as cardiac contusion, and CK with skeletal muscle injuries, their specificity for identifying coronary injuries is limited ( 1 - 3 , 5 , 7 , 8 , 18 , 20 , 21 ). Additionally, coronary artery injury can result in arrhythmias and signs of infarct.…”

Section: Evaluation and Treatments Of Blunt Cardiac Traumamentioning

confidence: 99%

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Blunt cardiac trauma: a narrative review

EL‐Andari¹,

O’Brien²,

Bozso³

et al. 2021

Mediastinum

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Objective This review aims to summarize the literature regarding blunt cardiac trauma (BCT), focusing on the mechanism of injury, presentations, diagnostic, and treatment approaches to provide an up-to-date perspective and to identify the areas requiring further investigation. Background BCT is a relatively rare, but likely underdiagnosed, consequence of blunt chest trauma. BCT occurs in less than 10% of all trauma admissions although it is responsible for approximately 25% of traumatic deaths. BCT often occurs due to forceful impact, rapid deceleration, or crush injuries and the most common causes include motor vehicle accidents, pedestrians struck by motor vehicles, and falls from a significant height. While BCT is certainly an important condition with significant clinical implications, the current literature is limited comprised of mainly case reports. BCTs are often complex cases with various presentations, comorbid injuries, diagnostic modalities, and treatments. Methods PubMed was searched for retrospective, prospective, randomized control trials, case report studies, and previous related reviews investigating BCT published from January 1, 1985 to February 1, 2021. Exclusion criteria included if the full length manuscript was not available and if insufficient data was provided regarding the patient outcomes or the case presented in case reports. Conclusions A wide variety of injuries, mechanisms, presentations, and treatments are possible with BCT. Commonalities in initial investigations include a thorough history and physical exam where appropriate, lab work to evaluate patient status, and imaging to diagnose structural injuries. Treatment often begins with stabilization of the patient and rapid initiation of interventions aimed at underlying structural or rhythm abnormalities. As the current literature is limited, further study into BCT is necessary. As BCT is relatively rare and occurs sporadically at individual centers, widespread data collection from BCT patients regarding their treatment and outcomes is essential in order to collect the required data for retrospective or prospective studies. The widespread establishment of multicenter or national databases may be a solution to address the limited data in this field allowing identification of optimal treatments for BCT patients, addressing the limitations in the field of BCT, and allow the continued improvement in the outcomes of patients who experience BCT.

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