Trauma to the heart: A review of presentation, diagnosis, and treatment

Goldstein, Adam; Soffer, Dror

doi:10.1097/ta.0000000000001667

Cited by 13 publications

(5 citation statements)

References 50 publications

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“…Thus, a high clinical suspicion based on mechanism of injury and meticulous evaluation, using focused assessment with sonography in trauma (FAST) examination and other studies, along with early intervention, are crucial for favorable outcome. [8][9][10] Injuries and outcomes after traumatic cardiac injuries have been described in many reports; however, almost all of these are institutional-based studies with few population-based analyses.…”

mentioning

confidence: 99%

Ten-Year Trends in Traumatic Cardiac Injury and Outcomes: A Trauma Registry Analysis

Tran

Charles

Garrett

et al. 2020

The Annals of Thoracic Surgery

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mentioning

confidence: 99%

Ten-Year Trends in Traumatic Cardiac Injury and Outcomes: A Trauma Registry Analysis

Tran

Charles

Garrett

et al. 2020

The Annals of Thoracic Surgery

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“…Structural injuries to the heart, such as ruptures of the myocardial wall or the valve apparatus, are clinically rare [17][18][19] whereby a relevant preclinical mortality is pointed out here. A partial amputation of the left atrial appendage could be treated without median sternotomy and use of extracorporeal circulation: a left atrial appendage (LAA) clip was used here, which is usually used for occlusion of the atrial appendage in rhythm surgery [20].…”

Section: Discussion: Clinical Relevance Of Cardiac Injuries In Blunt ...mentioning

confidence: 92%

Thoracic Trauma with Suspected Cardiac Injury on Admission: How Often Is a Cardiothoracic Surgeon Required

Reindl

2022

JTCS

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Introduction: Cardiac involvement in the setting of thoracic trauma is possible with both blunt and penetrating mechanisms. Overall, structural cardiac injury is rare, but when it occurs, it requires immediate diagnosis. We evaluated our process in decision-taking and further surgical procedures if necessary. The aim of this retrospective study is (1) the analysis of cardiac injury patterns and their therapeutic approaches, (2) in how many of these cases a cardiothoracic surgeon is needed in trauma room care and (3) in how many patients cardiothoracic surgery was indicated. Patients and Methods: We analyzed all blunt and penetrating trauma patients with suspected cardiac injury at the time of admission between 7/2016 and 7/2021. Sonography, cardiac enzymes, and electrocardiography were obtained obligatorily. Computed tomography (CT) was carried out in hemodynamically stable patients. Trauma room protocols were analyzed including available Injury Severy Scores (ISS). Data on cardiac injuries, operations, access routes, outcomes and hospitalization were evaluated. Results: In total, 43 patients with cardiac injury at the time of admission could be identified. Contusio cordis was detected in 27 patients (63%), in whom conservative therapy was performed. We indicated surgical intervention in 16 patients (37.2%): nine patients (21%) after blunt chest trauma with cardiac or pericardial injuries, mean ISS 37.3 (9.7). These included tricuspid regurgitation after traumatic rupture of chordae tendineae and rupture of the left atrial appendage. Seven patients (16%) underwent surgery for penetrating chest trauma: six for cardiac knife injury, one patient for iatrogenic drainage dislocation in the left ventricle. Mortality was 22% in surgically treated blunt trauma patients, whereas no mortality was observed in penetrating trauma. Discussion: The most common cardiac injury after blunt thoracic trauma is contusio cordis. In these patients’ surgical treatment is usually not necessary. In contrast, thoracic trauma with structural cardiac injury needs a coordinated and interdisciplinary management in a center with cardiothoracic surgery. In addition to anamnesis and clinical examination, sonography with echocardiography and CT in particular play a decisive role in a rapid diagnosis. In the patients presented in this study, more than every third case required cardiothoracic surgery (16 out of 43 patients, 37.2%). Thus, cardiothoracic expertise should be present for all trauma room patients with suspected cardiac injury.

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“…Evaluation of hemodynamically stable patients includes CT of the chest and/or abdomen with CT angiography to assess the thoracic aorta. 15 Management includes efforts to stop the bleeding and prevent contamination of the chest with abdominal contents in the case of concomitant abdominal trauma. If blood is seen in a subxiphoid pericardial window, sternotomy and open exploration of the chest may be required, particularly in the setting of hemodynamic instability.…”

Section: Adult Cardiac and General Thoracic Emergenciesmentioning

confidence: 99%

A primer for students regarding advanced topics in cardiothoracic surgery, part 1: Primer 6 of 7

et al. 2023

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Trauma to the heart: A review of presentation, diagnosis, and treatment

Cited by 13 publications

References 50 publications

Ten-Year Trends in Traumatic Cardiac Injury and Outcomes: A Trauma Registry Analysis

Ten-Year Trends in Traumatic Cardiac Injury and Outcomes: A Trauma Registry Analysis

Thoracic Trauma with Suspected Cardiac Injury on Admission: How Often Is a Cardiothoracic Surgeon Required

A primer for students regarding advanced topics in cardiothoracic surgery, part 1: Primer 6 of 7

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