Blunt Cardiac Injury
Traumatic cardiac injuries include a spectrum of injuries:
- Minor arrhythmias
- Complex arrhythmias
- Free-wall rupture
Usually fatal. - Acute heart failure
Due to:- Significant muscular injury
- Septal rupture
Left-to-right shunt. - Valvular injury
Regurgitation. - Coronary arterial injury
Epidemiology and Risk Factors
Pathophysiology
Injuries occur via a number of different mechanisms:
- Compression of the heart between sternum and spine
- Abrupt pressurisation of the cardiac chambers
- Shearing of the heart on the vascular pedicle following rapid deceleration
Aetiology
Clinical Manifestations
Diagnostic Approach and DDx
Significant injury is rare if:
- Young
- Haemodynamically stable
- Normal ECG
Investigations
Bedside:
Laboratory:
Imaging:
Other:
Management
Resuscitation:
Specific therapy:
- Pharmacological
- Procedural
- Physical
Supportive care:
Disposition:
Preventative:
Marginal and Ineffective Therapies
Anaesthetic Considerations
Complications
Prognosis
Key Studies
References
- Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.