Role of Imaging in Penetrating and Blunt Traumatic Injury to the Heart

Abstract

Cardiac injury due to blunt or penetrating chest trauma is common and is associated with significant morbidity and mortality. Understanding the mechanisms, types, and complications of cardiac injuries and the roles of various imaging modalities in characterizing them is important for appropriate diagnosis and treatment. These injuries have not been well documented at imaging, but there are now fast and accurate methods for evaluating the heart and associated mediastinal structures. The authors review the broad spectrum of injuries that can result from blunt or penetrating trauma to the chest, as well as the imaging modalities commonly used in the acute trauma setting for evaluation of the heart and mediastinal structures. A pictorial review of both common and, to date, rarely documented cardiac injuries imaged with a variety of modalities is also presented. While many imaging modalities are available, the authors demonstrate the value of multidetector computed tomography (CT) for the initial evaluation of patients with blunt or penetrating chest trauma. With the advent of multidetector CT, imaging of cardiac injury has increased and accurate identification of these rare but potentially lethal injuries has become paramount for improving survival. Selection of the most appropriate modality for evaluation and recognition of the imaging findings in cardiac injuries in the acute trauma setting is important to expedite treatment and improve survival.

An Evaluation of Factors Affecting Clinical Outcomes in Penetrating Cardiac Injuries: A Single Centre Experience

“…[1,3] In previous reports, injured cardiac site of PCI was listed as right ventricle (35%), left ventricle (25%), right atrium (33%), left atrium (14%), and aorta (14%). [3] When possible with vitally stable patients, diagnostic methods can facilitate approach of clinician.…”

“…[1,3] In previous reports, injured cardiac site of PCI was listed as right ventricle (35%), left ventricle (25%), right atrium (33%), left atrium (14%), and aorta (14%). [3] When possible with vitally stable patients, diagnostic methods can facilitate approach of clinician. [1,3] Chest radiogram can provide evidence of concomitant lung injury, but it is inadequate to evaluate injuries involving the heart and the pericardium.…”

“…[3] When possible with vitally stable patients, diagnostic methods can facilitate approach of clinician. [1,3] Chest radiogram can provide evidence of concomitant lung injury, but it is inadequate to evaluate injuries involving the heart and the pericardium. Echocardiography, which is non-invasive and easily available, can provide knowledge about valvular function, wall motion, and left ventricular ejection fraction, which are helpful for detecting pericardial effusion and tamponade.…”

“…Echocardiography, which is non-invasive and easily available, can provide knowledge about valvular function, wall motion, and left ventricular ejection fraction, which are helpful for detecting pericardial effusion and tamponade. [3] However, device wires, tubes, wound dressings, or chest bleeding, and even electrocardiogram cables and lead wires, often limit visualization of echocardiogram. [1,3] Multidetector computed tomography (CT) is highly sensitive for evaluation of lung and cardiac structures.…”

“…[3] However, device wires, tubes, wound dressings, or chest bleeding, and even electrocardiogram cables and lead wires, often limit visualization of echocardiogram. [1,3] Multidetector computed tomography (CT) is highly sensitive for evaluation of lung and cardiac structures. It can help identify wound track of penetrating trauma and guide clinicians.…”