Cardiac Trauma
Summary: <br> Cardiac tamponade. Aortic Dissection. Blunt cardiac injury.<br> <br> <br> <br> Cardiac Tamponade<br> <br> <br> <br> * Blood fills pericardial sac* Increasing pressure on myocardium -> Decreased preload* Decreased preload -> Hypotension -> Death* Clinical exam shows Beck’s Triad* Hypotension* Muffled heart sounds* Jugular venous distension (JVD)* Diagnosed during FAST exam (subxiphoid view)* Treat with pericardiocentesis* Bedside thoracotomy if patient loses pulse<br> <br> <br> <br> Aortic Dissection/Rupture/Tear<br> <br> <br> <br> * Common with rapid deceleration injuries* Most commonly occurs at ligamentum arteriosum* Small ligament that attaches arch of aorta to pulmonary artery* Remnant of the ductus arteriosus* Obtain CTA of the chest if…* Widened mediastinum on chest x-ray* Unequal pulses* Concerning mechanism of injury* Requires emergent repair<br> <br> <br> <br> Blunt Cardiac Injury<br> <br> <br> <br> * Contusion to the myocardium can cause arrhythmia/death* Place patient on cardiac monitor* Consider EKG/troponin* Commotio Cordis* Blunt impact to chest resulting in ventricular fibrillation<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Blunt Cardiac Injury <a href="https://www.aast.org/blunt-cardiac-injury#:~:text=Blunt%20cardiac%20injury%20%28BCI%29%20refers%20to%20injury%20sustained,silent%2C%20transient%20arrhythmias%20to%20deadly%20cardiac%20wall%20rupture.">(American Association for the Surgery of Trauma)</a>* FAST Exam <a href="https://www.saem.org/cdem/education/online-education/m3-curriculum/bedside-ultrasonagraphy/fast-exam#!#:~:text=%20FAST%20examination%20%201%20Objectives.%20Describe%20the,recommend%20using%20a...%204%20Views.%20%20More%20">(SAEM)</a><br>
