Blunt Cardiac Injury

Definition: Encompasses wide spectrum of clinical injuries, ranging from asymptomatic myocardial bruise to cardiac rupture/death

No gold standard

Pearls:

• Causes 20% of all deaths due to motor vehicle collisions
• Most commonly injured chamber: Right ventricle (most anterior in chest)

Clinical tips:

• Suspect in anyone with significant blunt, deceleration, or crush trauma to chest
• Consider BCI in hemodynamically unstable patients without alternative cause
• Troponin I and T lack adequate sensitivity as screening test

Suggested algorithm, based on available evidence

References

• Bernardin B, Troquet JM. Initial management and resuscitation of severe chest trauma. EM Clinics of North Am. 2012;30:377-400. [PubMed]