Management of Thoracic and Cardiac Trauma: A Case Series and Literature Review

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2022 Jul 8

PMID 35800197

Authors

Akshay Kumar

Nimisha Shiwalkar

Sameer Bhate

Suresh Keshavamurthy

Affiliations

Soon will be listed here.

Abstract

Patients with cardiac and thoracic trauma remain one of the most difficult presentations to diagnose and treat in an emergency room setting. Here, we present our series of four cases of cardiac and thoracic trauma with varied presentations, including lung, vascular, and diaphragmatic injuries that were managed successfully. We further review the manifestations of cardiac trauma, including cardiac contusions, cardiac rupture, pericardial injury, and valvular injuries; thoracic trauma, including lung and diaphragmatic injury. The sheer complexity of the anatomical structures within the thorax makes it of the utmost importance to timely and appropriately manage them.

Citing Articles

Spontaneous Right-Sided Diaphragmatic Hernia: A Rare Cause of Small Bowel Obstruction.

Douzenis P, Mohamedahmed A, Sukumaran S, Muras Z, Husain N Cureus. 2024; 16(4):e59279.

PMID: 38813327 PMC: 11135242. DOI: 10.7759/cureus.59279.

Ventricular Septal Defect and Mitral Regurgitation Due to Penetrating Cardiac Trauma; a Case Report and Review of Literature.

Mortezaeian H, Tabib A, Pouraliakbar H, Anafje M, Ebrahimi P, Soltani P Arch Acad Emerg Med. 2024; 12(1):e25.

PMID: 38572216 PMC: 10988181. DOI: 10.22037/aaem.v12i1.2267.

References

Doerer J, Haas T, Estes 3rd N, Link M, Maron B . Evaluation of chest barriers for protection against sudden death due to commotio cordis. Am J Cardiol. 2007; 99(6):857-9. DOI: 10.1016/j.amjcard.2006.10.053. View

Tarmiz A, Lopez S, Honton B, Riu B . Surgical repair of rupture of the membranous septum after blunt chest trauma. Ann Thorac Surg. 2010; 91(1):e3-4. DOI: 10.1016/j.athoracsur.2010.08.073. View

Bjornstad J, Pillgram-Larsen J, Tonnessen T . Coronary artery dissection and acute myocardial infarction following blunt chest trauma. World J Emerg Surg. 2009; 4:14. PMC: 2672072. DOI: 10.1186/1749-7922-4-14. View

Evans J, GRAY Jr L, Rayner A, Fulton R . Principles for the management of penetrating cardiac wounds. Ann Surg. 1979; 189(6):777-84. PMC: 1397211. DOI: 10.1097/00000658-197906000-00015. View

Salim A, Velmahos G, Jindal A, Chan L, Vassiliu P, Belzberg H . Clinically significant blunt cardiac trauma: role of serum troponin levels combined with electrocardiographic findings. J Trauma. 2001; 50(2):237-43. DOI: 10.1097/00005373-200102000-00008. View

Thourani V, Feliciano D, Cooper W, Brady K, Adams A, Rozycki G . Penetrating cardiac trauma at an urban trauma center: a 22-year perspective. Am Surg. 1999; 65(9):811-6; discussion 817-8. View

Wani M, Ahangar A, Wani S, Irshad I, Ul-Hassan N . Penetrating cardiac injury: a review. Trauma Mon. 2014; 17(1):230-2. PMC: 4004985. DOI: 10.5812/traumamon.3461. View

Berk W . ECG findings in nonpenetrating chest trauma: a review. J Emerg Med. 1987; 5(3):209-15. DOI: 10.1016/0736-4679(87)90180-6. View

Collins J, Cole F, Weireter L, Riblet J, Britt L . The usefulness of serum troponin levels in evaluating cardiac injury. Am Surg. 2001; 67(9):821-5; discussion 825-6. View

10.

Kokotsakis J, Hountis P, Antonopoulos N, Skouteli E, Athanasiou T, Lioulias A . Intravenous adenosine for surgical management of penetrating heart wounds. Tex Heart Inst J. 2007; 34(1):80-1. PMC: 1847917. View

11.

Turk E, Tsang Y, Champaneri A, Pueschel K, Byard R . Cardiac injuries in car occupants in fatal motor vehicle collisions--an autopsy-based study. J Forensic Leg Med. 2010; 17(6):339-43. DOI: 10.1016/j.jflm.2010.05.005. View

12.

Saxena A, Ramasamy S, Devagourou V, Math R . Ventricular septal rupture in a 4-year-old child following blunt chest injury. Pediatr Cardiol. 2009; 30(8):1188-9. DOI: 10.1007/s00246-009-9529-8. View

13.

Hamdan-Challe M, Godin M, Bouchart F, Doguet F . Isolated ventricular septal rupture secondary to blunt trauma. Interact Cardiovasc Thorac Surg. 2010; 11(5):667-9. DOI: 10.1510/icvts.2010.242602. View

14.

James M, Verhofste M, Franklin C, Beilman G, Goldman C . Dissection of the left main coronary artery after blunt thoracic trauma: Case report and literature review. World J Emerg Surg. 2010; 5:21. PMC: 2914738. DOI: 10.1186/1749-7922-5-21. View

15.

Kim Y, Yoo B, Choi J, Sul J, Park Y . Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury. Korean J Pediatr. 2011; 54(2):86-9. PMC: 3077506. DOI: 10.3345/kjp.2011.54.2.86. View

16.

Lobay K, MacGougan C . Traumatic coronary artery dissection: a case report and literature review. J Emerg Med. 2010; 43(4):e239-43. DOI: 10.1016/j.jemermed.2010.04.019. View

17.

Kaptein Y, Talving P, Konstantinidis A, Lam L, Inaba K, Plurad D . Epidemiology of pediatric cardiac injuries: a National Trauma Data Bank analysis. J Pediatr Surg. 2011; 46(8):1564-71. DOI: 10.1016/j.jpedsurg.2011.02.041. View

18.

Decavele M, Gault N, Gauss T, Pease S, Moyer J, Paugam-Burtz C . Cardiac troponin I as an early prognosis biomarker after trauma: a retrospective cohort study. Br J Anaesth. 2018; 120(6):1158-1164. DOI: 10.1016/j.bja.2018.03.010. View

19.

Huis In t Veld M, Craft C, Hood R . Blunt Cardiac Trauma Review. Cardiol Clin. 2017; 36(1):183-191. DOI: 10.1016/j.ccl.2017.08.010. View

20.

Karmy-Jones R, van Wijngaarden M, Talwar M, Lovoulos C . Penetrating cardiac injuries. Injury. 1997; 28(1):57-61. DOI: 10.1016/S0020-1383(96)00141-6. View