Document Detail

Relationship of echocardiographic and coronary angiographic findings in patients with acute myocardial infarction secondary to penetrating cardiac trauma.
MedLine Citation:
PMID:  22743380     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with cardiac wounds could experience a posttraumatic acute myocardial infarction (PAMI) as a complication. Usually, this complication is explained by occlusion of a coronary artery, but sometimes, it cannot be explained by this pathophysiologic finding. This study aimed to determine the incidence of PAMI, make an approximation of PAMI pathophysiology, and propose management strategies.
METHODS: A prospective observational study was conducted at San Vicente de Paul University Hospital in Medellin, Colombia. During 12 months, we studied 51 patients with a history of a cardiac stab injury. We evaluated variables, such as Revised Trauma Score (RTS), surgical and anesthetic data, and possible risk factors. Diagnosis of PAMI was based on electrocardiogram, echocardiography, and troponin I serum levels. All PAMI patients had an coronary angiography. Risk factors possibly related to the development of PAMI were explored.
RESULTS: Fifty-one patients were evaluated; three died (5.9%). Of the patients, 35 (68.62%) did not develop PAMI, 6 (11.76%) developed PAMI with coronary injury, and 10 (19.6%) experienced PAMI without coronary injury (PAMIWCI). An RTS of 5.3 or lower and a Glasgow Coma Scale score of 9 or lower were risk factors associated with PAMIWCI (relative risk, 11.55; p = 0.03). We did not find a relationship between PAMI and the use of psychoactive substances or other comorbidities.
CONCLUSION: Patients with penetrating cardiac trauma may develop PAMIWCI. Active search for PAMI must be done in all patients with cardiac stab wound trauma, even those without artery coronary injury or symptoms suggestive of coronary ischemia. It is likely that Glasgow Coma Scale score of 9 of lower and RTS of 5.3 of lower for patients with cardiac injury are associated with the development of PAMIWCI.
Wilfredy Castano; Carlos Hernando Morales; Juan Manuel Senior; William Yesid Benjumea; Jorge Sanchez
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  73     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-29     Completed Date:  2012-09-17     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  111-6     Citation Subset:  AIM; IM    
Department of General Surgery, Universidad de Antioquia, Colombia.
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MeSH Terms
Coronary Angiography*
Glasgow Coma Scale
Heart / physiopathology
Heart Injuries / complications*,  physiopathology,  radiography,  ultrasonography
Injury Severity Score
Middle Aged
Myocardial Infarction / etiology*,  physiopathology,  radiography,  ultrasonography
Prospective Studies
Risk Factors
Troponin I / blood
Wounds, Penetrating / complications,  physiopathology,  radiography,  ultrasonography
Reg. No./Substance:
0/Troponin I

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