%0 Journal Article
%T Blunt Cardiac Injury in Trauma Patients with Thoracic Aortic Injury
%A Rathachai Kaewlai
%A Marc A. de Moya
%A Antonio Santos
%A Ashwin V. Asrani
%A Laura L. Avery
%A Robert A. Novelline
%J Emergency Medicine International
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/848013
%X Trauma patients with thoracic aortic injury (TAI) suffer blunt cardiac injury (BCI) at variable frequencies. This investigation aimed to determine the frequency of BCI in trauma patients with TAI and compare with those without TAI. All trauma patients with TAI who had admission electrocardiography (ECG) and serum creatine kinase-MB (CK-MB) from January 1999 to May 2009 were included as a study group at a level I trauma center. BCI was diagnosed if there was a positive ECG with either an elevated CK-MB or abnormal echocardiography. There were 26 patients (19 men, mean age 45.1 years, mean ISS 34.4) in the study group; 20 had evidence of BCI. Of 52 patients in the control group (38 men, mean age 46.9 years, mean ISS 38.7), eighteen had evidence of BCI. There was a significantly higher rate of BCI in trauma patients with TAI versus those without TAI (77% versus 35%, ). 1. Introduction Blunt cardiac injury (BCI) is a very rare, but potentially fatal, condition that accounts for 12%¨C32% of trauma-related fatality [1¨C3]. Ruptured cardiac cavities, coronary arteries, or intrapericardial portion of major vessels typically result in death at the scene of the collision [2, 4]. Victims of relatively less severe cardiac injuries such as myocardial contusion, hemopericardium due to contusions or lacerations, valvular regurgitation, or myocardial infarction due to coronary artery injury may survive the initial trauma and thus present to the emergency department (ED) for evaluation [1, 5, 6]. Among those who arrived alive at the ED, BCI is associated with a high mortality rate of 89% [7]. The frequency of reported BCI in trauma patients is difficult to determine. It varies widely from 0.045% to 86%, depending on patient population, subpopulation, and a variety of factors that were considered to make the diagnosis [1, 4, 5, 7¨C10]. Patients who suffer BCI usually have multiple severe concomitant injuries of other organs, including the thoracic aorta. By itself, thoracic aortic injury (TAI) is considered a potentially fatal condition if left untreated [1, 11¨C15]. Therefore, a surgical or endovascular intervention is usually performed as a definitive treatment if the patient¡¯s condition allows. When an open thoracotomy or endovascular repair is expected, it is critical for treating physicians to evaluate all associated injuries to determine the need for immediate interventions and for preoperative risk assessment [16]. With the widespread use of CT in polytrauma patients, the diagnosis of TAI and coexisting injuries to the lungs, pleura, chest wall, and abdomen can
%U http://www.hindawi.com/journals/emi/2011/848013/