These findings coupled with the appropriate clinical presentation should trigger a further evaluation of potential life-threatening cardiac and pericardial injuries [61-63]. Attention should be paid in patients with cardiac implantable electronic devices for possible device header fracture, lead fracture, or lead migration [64]. A case report of chest trauma that resulted in device malfunction showed an abnormal angulation between the device header and the body of the generator on a lateral chest radiograph [65]. Although an AP chest radiograph is the first-line imaging in trauma patients, it is often limited in quality because of motion artifacts and overlying devices and garments. The evaluation of the mediastinum is also limited with only an AP projection image. Several studies have evaluated the diagnostic yield of the chest radiograph in the assessment of blunt thoracic injuries and have shown the value of using chest radiographs, especially when coupled with abdominal CT, chest CT, or a clinical decision score [23,66-73]. AP chest radiograph has a lower diagnostic yield for occult blunt traumatic injuries than chest CT, missing 80% of cases of hemothorax and 50% of vertebral and rib fractures compared with CT [68,69,72,73]. Hemothorax or hemopericardium can result from cardiac rupture and pericardial tamponade; sternal fracture can result in cardiac contusion or even rupture. Overall, chest radiography alone has limited ability to detect traumatic cardiac injuries. Blunt Chest Trauma-Suspected Cardiac Injury SPECT/CT MPI Rest and Stress There is no relevant literature regarding the use of Tc-99m SPECT/CT MPI rest and stress in a hemodynamically unstable patient with blunt trauma and possible cardiac injury. SPECT/CT MPI Rest Only There is no relevant literature regarding the use of Tc-99m SPECT/CT MPI rest only in a hemodynamically unstable patient with blunt trauma and possible cardiac injury.
Blunt Chest Trauma Suspected Cardiac Injury. These findings coupled with the appropriate clinical presentation should trigger a further evaluation of potential life-threatening cardiac and pericardial injuries [61-63]. Attention should be paid in patients with cardiac implantable electronic devices for possible device header fracture, lead fracture, or lead migration [64]. A case report of chest trauma that resulted in device malfunction showed an abnormal angulation between the device header and the body of the generator on a lateral chest radiograph [65]. Although an AP chest radiograph is the first-line imaging in trauma patients, it is often limited in quality because of motion artifacts and overlying devices and garments. The evaluation of the mediastinum is also limited with only an AP projection image. Several studies have evaluated the diagnostic yield of the chest radiograph in the assessment of blunt thoracic injuries and have shown the value of using chest radiographs, especially when coupled with abdominal CT, chest CT, or a clinical decision score [23,66-73]. AP chest radiograph has a lower diagnostic yield for occult blunt traumatic injuries than chest CT, missing 80% of cases of hemothorax and 50% of vertebral and rib fractures compared with CT [68,69,72,73]. Hemothorax or hemopericardium can result from cardiac rupture and pericardial tamponade; sternal fracture can result in cardiac contusion or even rupture. Overall, chest radiography alone has limited ability to detect traumatic cardiac injuries. Blunt Chest Trauma-Suspected Cardiac Injury SPECT/CT MPI Rest and Stress There is no relevant literature regarding the use of Tc-99m SPECT/CT MPI rest and stress in a hemodynamically unstable patient with blunt trauma and possible cardiac injury. SPECT/CT MPI Rest Only There is no relevant literature regarding the use of Tc-99m SPECT/CT MPI rest only in a hemodynamically unstable patient with blunt trauma and possible cardiac injury.