In summary, TTE is the first-line imaging modality used in evaluation of blunt cardiac trauma in patients with abnormal ECG and elevated cardiac troponins. US Echocardiography Transthoracic Stress There is no relevant literature regarding the use of TTE stress in suspected myocardial infarction in the trauma setting. Variant 2: Suspected cardiac injury following blunt trauma, hemodynamically unstable patient. Hemodynamically unstable patients are defined as persistent hypotension (systolic blood pressure <90 mm Hg or mean blood pressure <65 mm Hg) despite fluid resuscitation [17]. Hemodynamically unstable patients with ECG changes and elevated cardiac troponins worrisome for cardiac trauma are usually managed with advanced cardiac life support followed by echocardiography evaluation [7]. On the contrary, hemodynamically unstable patients with normal ECG and cardiac troponins are usually admitted for monitoring and echocardiography is only indicated for unstable patients with rising troponin levels [7]. Blunt Chest Trauma-Suspected Cardiac Injury CT Chest CT chest plays a complementary role in defining the extent of blunt cardiac trauma and is typically reserved for surgical planning in patients with ongoing symptoms and unclear clinical etiology [7]. For this purpose, CT in a hemodynamically unstable patient with blunt trauma is useful despite the lack of relevant literature to support this statement. CT Heart Function and Morphology CT heart in a hemodynamically unstable patient with blunt trauma and possible cardiac injury is useful in clinically indicated scenarios despite the lack of direct evidence. CTA Chest The use of CTA chest is helpful in a hemodynamically unstable patient with blunt trauma and possible cardiac injury if clinically indicated to define the extent of blunt chest trauma and identify concomitant thoracic injuries; it is also helpful for surgical planning.
Blunt Chest Trauma Suspected Cardiac Injury. In summary, TTE is the first-line imaging modality used in evaluation of blunt cardiac trauma in patients with abnormal ECG and elevated cardiac troponins. US Echocardiography Transthoracic Stress There is no relevant literature regarding the use of TTE stress in suspected myocardial infarction in the trauma setting. Variant 2: Suspected cardiac injury following blunt trauma, hemodynamically unstable patient. Hemodynamically unstable patients are defined as persistent hypotension (systolic blood pressure <90 mm Hg or mean blood pressure <65 mm Hg) despite fluid resuscitation [17]. Hemodynamically unstable patients with ECG changes and elevated cardiac troponins worrisome for cardiac trauma are usually managed with advanced cardiac life support followed by echocardiography evaluation [7]. On the contrary, hemodynamically unstable patients with normal ECG and cardiac troponins are usually admitted for monitoring and echocardiography is only indicated for unstable patients with rising troponin levels [7]. Blunt Chest Trauma-Suspected Cardiac Injury CT Chest CT chest plays a complementary role in defining the extent of blunt cardiac trauma and is typically reserved for surgical planning in patients with ongoing symptoms and unclear clinical etiology [7]. For this purpose, CT in a hemodynamically unstable patient with blunt trauma is useful despite the lack of relevant literature to support this statement. CT Heart Function and Morphology CT heart in a hemodynamically unstable patient with blunt trauma and possible cardiac injury is useful in clinically indicated scenarios despite the lack of direct evidence. CTA Chest The use of CTA chest is helpful in a hemodynamically unstable patient with blunt trauma and possible cardiac injury if clinically indicated to define the extent of blunt chest trauma and identify concomitant thoracic injuries; it is also helpful for surgical planning.