Cardiac Injury as an Emergent Condition-Management and Treatment

Abstract

Background: Blunt cardiac injury (BCI) encompasses a broad spectrum of heart-related conditions, ranging from minor arrhythmias to fatal cardiac wall ruptures. The incidence of BCI is difficult to establish due to variations in clinical presentation and a lack of standardized diagnostic criteria. The most common form of BCI is cardiac contusion, although severe injuries like myocardial rupture can be life-threatening. Motor vehicle collisions (MVCs) are the primary cause, with rapid deceleration and direct trauma to the chest as the main mechanisms. Other contributing factors include rib fractures and high-impact trauma.

Aim: This article aims to review the management and treatment of blunt cardiac injury, focusing on diagnosis, clinical presentation, and intervention strategies. It highlights the mechanisms of injury, common pathologies, and challenges in diagnosing BCI.

Methods: A review of existing literature on BCI, including studies on the biomechanics of injury, clinical presentations, and diagnostic techniques such as echocardiography and biomarkers like troponin. The article also discusses treatment strategies and surgical interventions in managing severe cardiac injuries, particularly myocardial rupture and valvular injuries.

Results: Cardiac contusion is the most common injury, presenting symptoms such as chest pain, dyspnea, and arrhythmias. Severe cases may result in heart failure or require surgical intervention. Myocardial rupture and valvular injuries, though less frequent, carry higher mortality rates, particularly when patients do not reach medical care promptly. Surgical interventions such as pericardiocentesis and cardiorrhaphy are critical in stabilizing patients, with survival outcomes highly dependent on early diagnosis and timely surgical intervention.

Conclusion: BCI represents a significant challenge in trauma care due to its varied clinical presentation and the complexity of diagnosis and treatment complexity. Early recognition and intervention, including the use of advanced diagnostic tools like echocardiography, are essential for improving patient outcomes. Surgical repair techniques, including off-pump cardiorrhaphy, offer promising results in cases of severe myocardial rupture. Clinicians must maintain a high suspicion for BCI, especially in patients with high-risk trauma mechanisms such as MVCs.