CTA Chest Although this document excludes the discussion of vascular injuries, CTA chest without and with IV contrast is useful in a patient with blunt chest trauma and suspected cardiac injury. This is because CT chest can identify the extent of cardiac injury as well as other concomitant injuries in the chest and, most importantly, can be used for surgical planning. Blunt Chest Trauma-Suspected Cardiac Injury CTA Coronary Arteries Coronary CTA evaluates for potential posttraumatic coronary arterial dissection or occlusion resulting in myocardial infarction. There are limited data on the coronary CTA in patients with suspected myocardial infarction in the trauma setting. A case report has described various entities such as intramural hematomas or atypical dissection of the coronary artery [42] and enhancement defects in the myocardium suggestive of myocardial infarction in the setting of trauma. These findings triggered further imaging and subsequent intervention [21] to treat coronary artery dissection following blunt trauma [39]. Several case reports have described the use of coronary angiography as a diagnostic and therapeutic modality [40,43-46] to not only detect coronary artery dissection and thrombosis in patients with ECG abnormalities, or increased serum troponin level, but also treat with angioplasty or coronary artery stent placement. More recently, high-sensitivity cardiac troponins have become the mainstays in an emergency evaluation [7]. FDG-PET/CT Heart Cardiac fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT may be used to assess myocardial function, perfusion, and viability in the trauma setting. [37,47]. There are no data regarding the use of FDG-PET/CT heart in the setting of blunt chest trauma and suspected cardiac injury. MRI Heart Function and Morphology There are no data regarding the use of MRI heart in the setting of blunt chest trauma and suspected cardiac injury.
Blunt Chest Trauma Suspected Cardiac Injury. CTA Chest Although this document excludes the discussion of vascular injuries, CTA chest without and with IV contrast is useful in a patient with blunt chest trauma and suspected cardiac injury. This is because CT chest can identify the extent of cardiac injury as well as other concomitant injuries in the chest and, most importantly, can be used for surgical planning. Blunt Chest Trauma-Suspected Cardiac Injury CTA Coronary Arteries Coronary CTA evaluates for potential posttraumatic coronary arterial dissection or occlusion resulting in myocardial infarction. There are limited data on the coronary CTA in patients with suspected myocardial infarction in the trauma setting. A case report has described various entities such as intramural hematomas or atypical dissection of the coronary artery [42] and enhancement defects in the myocardium suggestive of myocardial infarction in the setting of trauma. These findings triggered further imaging and subsequent intervention [21] to treat coronary artery dissection following blunt trauma [39]. Several case reports have described the use of coronary angiography as a diagnostic and therapeutic modality [40,43-46] to not only detect coronary artery dissection and thrombosis in patients with ECG abnormalities, or increased serum troponin level, but also treat with angioplasty or coronary artery stent placement. More recently, high-sensitivity cardiac troponins have become the mainstays in an emergency evaluation [7]. FDG-PET/CT Heart Cardiac fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT may be used to assess myocardial function, perfusion, and viability in the trauma setting. [37,47]. There are no data regarding the use of FDG-PET/CT heart in the setting of blunt chest trauma and suspected cardiac injury. MRI Heart Function and Morphology There are no data regarding the use of MRI heart in the setting of blunt chest trauma and suspected cardiac injury.