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Mini Review: Blunt Cardiac Injury

Unfortunately, there are no isolated tests one can perform to diagnose the condition; rather, the diagnosis relies on the overall clinical picture and clinical gestalt. While major complications are uncommon, BCI can be life-threatening and can result in ventricular wall rupture. More commonly, BCI manifests as clinically insignificant arrhythmias and mildly elevated troponins, indicating inconsequential myocyte injury.1

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Articles of Interest

Blunt Cardiac Injury (BCI)

There is no standard definition of blunt cardiac injury (BCI). In general, BCI refers to any blunt trauma to the heart.

Paucis Verbis: Blunt cardiac injury

Do you always get a troponin for patients who sustain blunt chest trauma? Hopefully your answer is no. Of note, it is also NOT indicated as a screening test for those in whom you suspect a blunt cardiac injury (BCI). It can be normal in the setting of arrhythmias and it can be falsely elevated in the setting of catecholamine release or reperfusion injury from hypovolemic shock. The initial screening test should include an ECG and a FAST ultrasound exam. If you have abnormal ECG findings, then a troponin is warranted (in addition to hospital admission).

Resources

Life in the Fastlane

Blunt Cardiac Injury: spectrum from asymptomatic with minor enzyme rises to fulminant cardiac failure.