Document Detail


The role of echocardiography in blunt chest trauma: a transthoracic and transesophageal echocardiographic study.
MedLine Citation:
PMID:  8295249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies assessing the value of transthoracic echocardiography (TTE) in blunt chest trauma are limited because patients with severe chest wall injury often have suboptimal echocardiographic findings. Transesophageal echocardiography (TEE) can provide high quality images when the transthoracic image quality is poor. To provide complete echocardiographic assessment of cardiac structure and function we prospectively performed TTE in 105 patients with severe blunt chest trauma and TEE in 20 of the 105 patients (19%) whose TTE examination results were suboptimal. Myocardial contusion was diagnosed in 31 patients (30%), 22 by TTE and nine by TEE. Cardiac complications developed in 8 of 31 patients (26%) with myocardial contusion compared with 2 of 74 patients (3%) with normal echocardiographic findings (p = 0.001). Cardiac complications required treatment in only four patients. Echocardiography was of value in detecting severe right ventricular dysfunction as the cause of hypotension in two patients with suspected cardiac tamponade. Four patients with myocardial contusion died compared with two patients with normal echocardiographic findings (p = NS). No death was related to the cardiac status. In addition, TEE detected aortic injury in five patients, four with focal intimal tears and one with an aortic transection. We conclude that myocardial contusion is common following blunt chest trauma, rarely requires treatment, and is associated with a favorable prognosis. Only patients who develop cardiac complications benefit from echocardiography. Transesophageal echocardiography is of value when the TTE examination results are suboptimal and when aortic injury is suspected.
Authors:
D G Karalis; M F Victor; G A Davis; M P McAllister; V A Covalesky; J J Ross; R V Foley; M D Kerstein; K Chandrasekaran
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  36     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-03-02     Completed Date:  1994-03-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hahnemann University Hospital, Philadelphia, PA 19102.
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MeSH Terms
Descriptor/Qualifier:
Abbreviated Injury Scale
Adolescent
Adult
Aged
Arrhythmias, Cardiac / epidemiology,  etiology,  ultrasonography
Child
Creatine Kinase / blood
Echocardiography, Transesophageal / methods*
Female
Heart Injuries / blood,  epidemiology,  etiology,  ultrasonography
Humans
Hypotension / epidemiology,  etiology,  ultrasonography
Incidence
Isoenzymes
Male
Middle Aged
Prospective Studies
Thoracic Injuries / complications,  epidemiology,  ultrasonography*
Wounds, Nonpenetrating / complications,  epidemiology,  ultrasonography*
Chemical
Reg. No./Substance:
0/Isoenzymes; EC 2.7.3.2/Creatine Kinase

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