CT Heart Function and Morphology ECG-gated cardiac CT with IV contrast can be used in the trauma setting to evaluate the cardiac structure and can detect cardiac chamber rupture and pericardial rupture [35]. A case report has described various entities such as rupture of the right ventricle with contained contrast extravasation [36], left atrial appendage tear, rupture of the atria at the junction with pulmonary veins, and inferior vena cava. The existing literature focuses on clinical decision scores along with a chest radiograph, ECG, and troponin assessment [37] as a screening algorithm to triage patients in whom cardiac CT has the potential to guide life-saving interventions. Cardiac CT has been demonstrated to be highly accurate for the detection of cardiac structural abnormalities in the nontrauma setting. A case report described the right ventricular pseudoaneurysm following an MVA diagnosed with cardiac CT and missed with echocardiography [36]. Another case report described contrast extravasation from the apical portion of the right ventricle into the pericardial space compatible with contained ventricular rupture in addition to multiple chest injuries detected at CT [38]. Other case reports have described the ability of contrast-enhanced CT chest to detect 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]. In addition, another case report described a patient with a hemothorax caused by a left atrial appendage rupture, pleuropericardial tear, and cardiac herniation through the pericardium [40]. Moreover, case reports have described the ability of CT chest with IV contrast to detect enhancement defect in the myocardium suggestive of myocardial infarction and ventricular septal defect in the setting of trauma that triggered further imaging and intervention [6,21,41].
Blunt Chest Trauma Suspected Cardiac Injury. CT Heart Function and Morphology ECG-gated cardiac CT with IV contrast can be used in the trauma setting to evaluate the cardiac structure and can detect cardiac chamber rupture and pericardial rupture [35]. A case report has described various entities such as rupture of the right ventricle with contained contrast extravasation [36], left atrial appendage tear, rupture of the atria at the junction with pulmonary veins, and inferior vena cava. The existing literature focuses on clinical decision scores along with a chest radiograph, ECG, and troponin assessment [37] as a screening algorithm to triage patients in whom cardiac CT has the potential to guide life-saving interventions. Cardiac CT has been demonstrated to be highly accurate for the detection of cardiac structural abnormalities in the nontrauma setting. A case report described the right ventricular pseudoaneurysm following an MVA diagnosed with cardiac CT and missed with echocardiography [36]. Another case report described contrast extravasation from the apical portion of the right ventricle into the pericardial space compatible with contained ventricular rupture in addition to multiple chest injuries detected at CT [38]. Other case reports have described the ability of contrast-enhanced CT chest to detect 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]. In addition, another case report described a patient with a hemothorax caused by a left atrial appendage rupture, pleuropericardial tear, and cardiac herniation through the pericardium [40]. Moreover, case reports have described the ability of CT chest with IV contrast to detect enhancement defect in the myocardium suggestive of myocardial infarction and ventricular septal defect in the setting of trauma that triggered further imaging and intervention [6,21,41].