Usefulness of transthoracic and transoesophageal echocardiography in recognition and management of cardiovascular injuries after blunt chest trauma.

Chirillo, Fabio; Totis, Oscar; Cavarzerani, A; Bruni, Andrea; Farnia, Antonio; Sarpellon, M; Ius, Paolo; Valfré, Carlo; Stritoni, P

doi:10.1136/hrt.75.3.301

Cited by 155 publications

(49 citation statements)

References 32 publications

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“…MR findings consistent with TAI are similar to those of CT angiography and include intraluminal mass, flap, or luminal irregularity, as well as pseudoaneurysm, and hematoma (Wintermark, et al, 2002). CE-MRA can be used for diagnosis with a sensitivity and specificity between 98-100% (Bruckner, et al, 2006;Chirillo, et al, 1996;Fattori, et al, 1996;Khalil, et al, 2007;Mirvis&Shanmuganathan. 2000).…”

Section: Thoracic Aortamentioning

confidence: 86%

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Kobayashi¹,

Coimbra²

2012

Vascular Surgery

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Section: Thoracic Aortamentioning

confidence: 86%

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Kobayashi¹,

Coimbra²

2012

Vascular Surgery

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“…To this end, TTE and transesophageal echocardiography (TEE) are found to be specifically helpful in the MC diagnosis [21,22]. In this regard, especially the TEE was reported [23,24] to have high sensitivity (57-100%) and specificity (87-100%).…”

Section: Discussionmentioning

confidence: 99%

Dobutamine Stress Echocardiography Assessment of Myocardial Contusion due to Blunt Impact in Dogs

Xiong

Yang

et al. 2011

Cell Biochem Biophys

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We sought to investigate the role of two-dimensional stress echocardiography in the early assessment of myocardial contusion. For this purpose, 12 dogs, weighing 11.36 ± 1.50 kg, were selected and the myocardial contusion was experimentally induced. Two-dimensional dobutamine stress echocardiography (DSE) was used to detect abnormal myocardial motions segments at time phases of baseline and 0.5, 2, 4, and 8 h post-wounding. Finally, the above results were compared with pathological findings. The data show that after the dogs were induced to have severe myocardial contusion, 122 segments were found with abnormal myocardial wall motions at 0.5 h post-wounding, 133 segments at 2 h post-wounding, and 142 segments, each, at 4 h and 8 h post-wounding. The wall motion score (WMS) and wall motion score index (WMSI) increased (P < 0.001) as compared with the pre-impaction values. Considering the left ventricular axis view as the standard section, in the 60 segments examined by echocardiography, 54 segments were found to have wall motion abnormalities. Comparing with the results of pathological TTC staining, the sensitivity and specificity were found to be 100 and 66.6%, respectively. It was, therefore, concluded that two-dimensional DSE was a valuable technique in the early diagnosis of myocardial contusion due to its better sensitivity and specificity.

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“…Although useful in the fast exam to evaluate for pericardial effusion, an increased skillset is required to interpret the subtle findings that may be associated with CC. Another major limitation is the poor images obtained when patients have severe chest wall or thoracic trauma that can limit the ability to detect CC [30,31].…”

Section: Echocardiographymentioning

confidence: 99%

Cardiac Contusions

Brewer

Zarzaur

2015

Curr Trauma Rep

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Cardiac contusion has been one of the most discussed topics in the trauma community. The discussions are centered around appropriate nomenclature, screening mechanisms, diagnostic modalities, and ultimately management principles. Controversy over nomenclature exists because cardiac contusion has been used to describe an array of injuries ranging from a transient arrhythmia to free rupture of the myocardial wall. The mainstays of screening have been electrocardiograms and cardiac isoenzymes. Although there is a substantial body of literature, few other screening or diagnostic modalities have been widely accepted. Echocardiography has gained favor as a confirmatory test and to determine presence or extinct of structural damage. Management has traditionally been supportive including volume repletion, correcting arrhythmias, and repairing structural damage. Recently, there has been some promising alternative treatments including transcatheter closure of ventricular septal defects, anti-inflammatory agents, and post-injury therapeutic hypothermia. Although screening and diagnostic mechanism have remained relatively unchanged, it appears that innovative management of severe cardiac contusions has gained some momentum over the recent years.

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Usefulness of transthoracic and transoesophageal echocardiography in recognition and management of cardiovascular injuries after blunt chest trauma.

Abstract: (Heart 1996;75:301-306)

Cited by 155 publications

References 32 publications

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Dobutamine Stress Echocardiography Assessment of Myocardial Contusion due to Blunt Impact in Dogs

Cardiac Contusions

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