State of the Art Imaging Review of Blunt and Penetrating Cardiac Trauma

Abstract

<jats:p> Traumatic cardiovascular injuries are only second to the central nervous system injuries as a cause of death in young adult population. Multidetector computed tomography is the gold standard diagnostic modality in patients with blunt or penetrating chest trauma and clinical suspicion of cardiac injury. The imaging spectrum of cardiac injuries includes but not limits to pericardial rupture, myocardial contusions, valve rupture, coronary artery injuries, cardiac herniations, and cardiac tamponade. In this review article, we discuss clinical presentation, types, and mechanism of cardiac trauma with emphasis on the imaging findings and illustrations in blunt, penetrating traumatic, and iatrogenic cardiac injuries. </jats:p>

Left ventricular rupture as a consequence of blunt trauma – case report and literature review

“…MDCT is the current gold standard for evaluating chest trauma due to its excellent spatial, contrast, and temporal resolution, which allows detailed analysis of the heart, pericardium, and great vessels. The technique enables quick and accurate imaging of the entire body, leading to efficient diagnosis and treatment of life-threatening injuries [14,15]. Furthermore, ultrasonography is useful in both diagnostic as well as a temporary therapeutic measures defined by ultrasound-guided pericardiocentesis [7].…”

Peran Ultrasonografi pada Tamponade Jantung Akut Akibat Trauma Tumpul Dada

“…4,6,[8][9][10] Computed Tomography scan (CT scan) adalah modalitas standar emas untuk diagnosis trauma toraks khususnya pada perlukaan jantung. 11 Namun, terdapat beberapa limitasi CT scan, seperti tingginya biaya dan paparan radiasi, serta tidak kompatibel untuk pasien dengan kondisi klinis tidak stabil. Ultrasonografi dapat menjadi alternatif modalitas pemeriksaan.…”

“…13 Pemeriksaan lain, seperti rontgen toraks, dapat menjadi salah satu modalitas untuk identifikasi cairan bebas di perikardium, akan tetapi dibutuhkan setidaknya akumulasi 200 mL cairan untuk mendapatkan gambaran siluet jantung yang membesar. 11,14 Meskipun tingkat sensitivitasnya cukup baik (71%), namun tingkat spesifisitasnya rendah (41%) untuk menilai efusi perikardium. 14 Electrical alternans dan low QRS voltage pada elektrokardiografi (EKG) merupakan tanda yang tidak spesifik dan tidak sensitif.…”

How to deliver an effective primary survey report for the trauma CT: A radiological and surgical perspective

“…In rare cases where cardiac contusion is evident on CT, findings range from myocardial rupture, with extravasation of contrast into the pericardial sac to valve rupture and coronary arterial injury. 30…”

“…In rare cases where cardiac contusion is evident on CT, findings range from myocardial rupture, with extravasation of contrast into the pericardial sac to valve rupture and coronary arterial injury. 30 Risk of death from thoracic injuries can be as high as 25%, however with improved pre-hospital care, survival following blunt deceleration injuries is on the increase. 31 Acute traumatic aortic injuries can range from subtle intimal injury to frank rupture with active extravasation and the radiologist needs to be able to rapidly recognize acute traumatic aortic injury to give the trauma team the most time to make a treatment plan.…”