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Blunt Cardiac Injury
Diagnosis of Blunt Cardiac Injury
ECG Echocardiography Cardiac enzymes Cardiac injury should be suspected in patients with significant chest trauma and any palpitations, arrhythmia, new cardiac murmur, or unexplained tachycardia or hypotension. Most patients with significant blunt chest trauma should have 12-lead ECG. With myocardial contusion, ECG may reveal ST segment changes that mimic cardiac ischemia or infarction. The most common conduction abnormalities include atrial fibrillation, bundle branch block (usually right), unexplained sinus tachycardia, and single or multiple premature ventricular contractions. How To Do E-FAST Examination is generally done during the initial resuscitation and may show wall motion abnormalities, pericardial fluid, or chamber or valvular rupture. Patients suspected of having blunt cardiac injury because of clinical, ECG, or E-FAST findings should have formal echocardiography to evaluate function and anatomic abnormalities. Cardiac markers (eg, troponin, creatine phosphokinase muscle band isoenzyme [CPK-MB]) are most useful to screen for and thus help exclude blunt cardiac injury. If cardiac markers and ECG are normal and there are no arrhythmias, blunt cardiac injury can be safely excluded. 