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Blunt cardiac trauma: a narrative review

OBJECTIVE: This review aims to summarize the literature regarding blunt cardiac trauma (BCT), focusing on the mechanism of injury, presentations, diagnostic, and treatment approaches to provide an up-to-date perspective and to identify the areas requiring further investigation. BACKGROUND: BCT is a...

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Autores principales: EL-Andari, Ryaan, O'Brien, Devin, Bozso, Sabin J., Nagendran, Jeevan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799926/
https://www.ncbi.nlm.nih.gov/pubmed/35118333
http://dx.doi.org/10.21037/med-21-19
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author EL-Andari, Ryaan
O'Brien, Devin
Bozso, Sabin J.
Nagendran, Jeevan
author_facet EL-Andari, Ryaan
O'Brien, Devin
Bozso, Sabin J.
Nagendran, Jeevan
author_sort EL-Andari, Ryaan
collection PubMed
description OBJECTIVE: This review aims to summarize the literature regarding blunt cardiac trauma (BCT), focusing on the mechanism of injury, presentations, diagnostic, and treatment approaches to provide an up-to-date perspective and to identify the areas requiring further investigation. BACKGROUND: BCT is a relatively rare, but likely underdiagnosed, consequence of blunt chest trauma. BCT occurs in less than 10% of all trauma admissions although it is responsible for approximately 25% of traumatic deaths. BCT often occurs due to forceful impact, rapid deceleration, or crush injuries and the most common causes include motor vehicle accidents, pedestrians struck by motor vehicles, and falls from a significant height. While BCT is certainly an important condition with significant clinical implications, the current literature is limited comprised of mainly case reports. BCTs are often complex cases with various presentations, comorbid injuries, diagnostic modalities, and treatments. METHODS: PubMed was searched for retrospective, prospective, randomized control trials, case report studies, and previous related reviews investigating BCT published from January 1, 1985 to February 1, 2021. Exclusion criteria included if the full length manuscript was not available and if insufficient data was provided regarding the patient outcomes or the case presented in case reports. CONCLUSIONS: A wide variety of injuries, mechanisms, presentations, and treatments are possible with BCT. Commonalities in initial investigations include a thorough history and physical exam where appropriate, lab work to evaluate patient status, and imaging to diagnose structural injuries. Treatment often begins with stabilization of the patient and rapid initiation of interventions aimed at underlying structural or rhythm abnormalities. As the current literature is limited, further study into BCT is necessary. As BCT is relatively rare and occurs sporadically at individual centers, widespread data collection from BCT patients regarding their treatment and outcomes is essential in order to collect the required data for retrospective or prospective studies. The widespread establishment of multicenter or national databases may be a solution to address the limited data in this field allowing identification of optimal treatments for BCT patients, addressing the limitations in the field of BCT, and allow the continued improvement in the outcomes of patients who experience BCT.
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spelling pubmed-87999262022-02-02 Blunt cardiac trauma: a narrative review EL-Andari, Ryaan O'Brien, Devin Bozso, Sabin J. Nagendran, Jeevan Mediastinum Review Article OBJECTIVE: This review aims to summarize the literature regarding blunt cardiac trauma (BCT), focusing on the mechanism of injury, presentations, diagnostic, and treatment approaches to provide an up-to-date perspective and to identify the areas requiring further investigation. BACKGROUND: BCT is a relatively rare, but likely underdiagnosed, consequence of blunt chest trauma. BCT occurs in less than 10% of all trauma admissions although it is responsible for approximately 25% of traumatic deaths. BCT often occurs due to forceful impact, rapid deceleration, or crush injuries and the most common causes include motor vehicle accidents, pedestrians struck by motor vehicles, and falls from a significant height. While BCT is certainly an important condition with significant clinical implications, the current literature is limited comprised of mainly case reports. BCTs are often complex cases with various presentations, comorbid injuries, diagnostic modalities, and treatments. METHODS: PubMed was searched for retrospective, prospective, randomized control trials, case report studies, and previous related reviews investigating BCT published from January 1, 1985 to February 1, 2021. Exclusion criteria included if the full length manuscript was not available and if insufficient data was provided regarding the patient outcomes or the case presented in case reports. CONCLUSIONS: A wide variety of injuries, mechanisms, presentations, and treatments are possible with BCT. Commonalities in initial investigations include a thorough history and physical exam where appropriate, lab work to evaluate patient status, and imaging to diagnose structural injuries. Treatment often begins with stabilization of the patient and rapid initiation of interventions aimed at underlying structural or rhythm abnormalities. As the current literature is limited, further study into BCT is necessary. As BCT is relatively rare and occurs sporadically at individual centers, widespread data collection from BCT patients regarding their treatment and outcomes is essential in order to collect the required data for retrospective or prospective studies. The widespread establishment of multicenter or national databases may be a solution to address the limited data in this field allowing identification of optimal treatments for BCT patients, addressing the limitations in the field of BCT, and allow the continued improvement in the outcomes of patients who experience BCT. AME Publishing Company 2021-09-25 /pmc/articles/PMC8799926/ /pubmed/35118333 http://dx.doi.org/10.21037/med-21-19 Text en 2021 Mediastinum. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Review Article
EL-Andari, Ryaan
O'Brien, Devin
Bozso, Sabin J.
Nagendran, Jeevan
Blunt cardiac trauma: a narrative review
title Blunt cardiac trauma: a narrative review
title_full Blunt cardiac trauma: a narrative review
title_fullStr Blunt cardiac trauma: a narrative review
title_full_unstemmed Blunt cardiac trauma: a narrative review
title_short Blunt cardiac trauma: a narrative review
title_sort blunt cardiac trauma: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799926/
https://www.ncbi.nlm.nih.gov/pubmed/35118333
http://dx.doi.org/10.21037/med-21-19
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