Blunt Cardiac Injury

Sat, 01/20/2018 - 12:02am
Author: 
Kim Chavez, MD

Blunt Cardiac Injury 

Screening for blunt cardiac injury in trauma patients is a necessary but occasionally challenging endeavor as these patients can develop cardiovascular compromise. Below are some quick pearls about not missing blunt cardiac injury (BCI) in your next trauma patient.

 

  • Per the EAST guidelines, your first step is obtaining an EKG if you suspect BCI.
  • If the EKG shows a new abnormality (ST changes, arrhythmias, ischemia), admit the patient for further cardiac monitoring.
  • If the EKG and troponin are negative, BCI is virtually ruled out.
  • A sternal fracture is not a predictive marker for BCI.

 

References

 

  1. Clancy, Keith MD; et al. Screening for blunt cardiac injury. EAST Guidelines. J Trauma. 73(5):S301-S306, November 2012.
  2. Ross C, Schwab T. Cardiac Trauma. In: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e New York, NY: McGraw-Hill; 2016. http://accessmedicine.mhmedical.com/content.aspx?bookid=1658&sectionid=1.... Accessed January 19, 2018.