UDK  616.12-001.3                       

ISSN 2466-2992 (Online) (2021) br.1, p. 28-34

COBISS.SR-ID 46956041

BLUNT CARDIAC INJURY

Dušica Janković1, Saša Ignjatijević1, Tatjana Mićić1, Snežana Mitrović1, Milan Elenkov2, Bejtula Ajeti3

1Emergency Medical Institute, Niš, Serbia, 2 General hospital Pirot, Department of Anaesthesiology, Serbia, 3Health center Bujanovac, Emergency Medical Service

Summary:

INTRODUCTION: Trauma is one of the leading causes of death worldwide. Blunt cardiac injuries (BCI) are generally seen in the setting of high impact trauma. Motor vehicle crashes, pedestrians being struck by motor vehicles and trauma secondary to falls are the most often causes of blunt cardiac injury. There are not enough guidelines of high Level of Evidence regarding BCI.

METHODS: A review of online database of relevant articles and available literature for the past 15 years.

RESULTS: Spectrum of cardiac injury can be classified, according to American Association for the surgery of Trauma (AAST) Injury scale, from Grade I to Grade IV, and they range from blunt cardiac injury with minor electrocardiogram abnormality (non-specific ST of T wave changes, premature atrial or ventricular contractions, or persistent sinus tachycardia) to blunt avulsion of the heart. Diagnosing for blunt cardiac injury (BCI) can be a wary difficult and challenging task. Injuries to the heart muscle, valvular injuries. High index of suspicion and careful evaluation of mechanism of injury is essential for timely diagnosing of BCI. It is of great importance to determine what diagnostic studies and tests are specific enough to rule out BCI. There have been few recommendations for screening for BCI and they all address admission electrocardiogram, transthoracic echocardiogram, transesophageal echocardiogram, cardiac enzymes (troponin and creatinine phosphokinase), computed tomography and magnetic resonance imaging. First Eastern Association for the Surgery of Trauma (EAST) published guidelines that suggest only one Level 1 guideline saying that admission electrocardiogram should be performed on all patients in whom BCI is suspected. Other guidelines are based on lower scientific evidence but can be useful in screening for BCI.

CONCLUSION: Diversity in presentation which is immense, is only one of the reasons why we should be “on alert” when we are facing patients who sustained high impact trauma. Limited diagnostic tools in prehospital settings, where majority of the injuries occur, prompt these patients to emergency departments (ED), preferably Level I Trauma centers. Detailed evaluation of most importance and we need stronger evidence to „rule out” while screening for BCI.

Keywords: blunt, cardiac trauma, guidelines

Korespondencija/Correspondence

 

Dušica JANKOVIĆ

Zavod za hitnu medicinsku pomoć Niš

Vojislava Ilića bb

18000 Niš

e-mail: drdusicaj@yahoo.com

Issue 2021-1- article 4

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