Tracy Exam #1 Flashcards
A few things can detect cardiac trauma.
radiography
electrocardiography
cardiac enzyme studies
Echo (TTE and TEE)
Cardiac trauma, we’re gonna do a TEE. Why? This structure in heart is especially enhanced visually.
It enhances imaging of cardiac structures.
Thoracic aorta especially good to see here.
Iatrogenic injury in regards to blunt chest trauma usu due to
CPR
Which are more common. Blunt injury or penetrating injury.
Blunt.
Life threatening results of cardiac trauma are usu from
Hemorrhage
Cardiac tamponade
A patient has cardiac blunt chest trauma. What are some consequences down the road for immediate survivors? (6)
MI
Aneurysms
VSDs
Valve damage
Recurrent pericarditis
Constrictive pericarditis
What are common forms of blunt chest trauma? (5)
Steering wheel contusion (Motor Vehicle Accident, or MVA)
Sport injury
Fall from heights
Blow from blunt object
CPR
3 hallmarks of blunt cardiac trauma… the pain from these hallmarks may mask what?
fractured ribs
fractured clavicle
fractured sternum
the pain from these fractures may mask underlying cardiac problems
in blunt cardiac trauma, it can be a good sign that there are overlying fractures. That means the impact was absorbed by bones and not entirely by
the heart.
Heart injury: Blunt trauma can affect the myocardium (7)
- contusion
- laceration
- rupture
- septal perforation
- aneurysm or pseudoaneurysm
- hemopericardium, tamponade
- thrombosis / systemic embolism
Heart injury: Blunt trauma can affect the pericardium (6)
- pericarditis
- postpericardiotomy syndrome
- constrictive pericarditis
- pericardial laceration
- hemorrhage
- cardiac herniation
Heart injury: Blunt trauma can affect the endocardial structures (4)
- papillary muscle rupture
- chordae tendineae rupture
- AV valve rupture
- semilunar valve rupture
Heart injury: Blunt trauma can affect the coronary arteries (3)
- thrombosis
- laceration
- fistula
pericardial effusion is usu associated with (cardiac injury). there is usu _______ and it can happen ________.
cardiac contusion
great vessel tear
myocardial tear
*there is usu blood
can happen immediately or over time
long term complication of pericardial effusion is
constrictive pericarditis
(cardiac injury) bloody pericardial effusion on echo looks
more echogenic
(cardiac injury) clots on echo look
more echogenic
(cardiac injury) serous effusion on echo look
less echogenic
(cardiac injury) located effusion on echo
use different views to ID
TEE pitfalls… what can be mistaken?
Eustachian Valve, mistaken for lesion
Chiari network, mistaken for lesion
Lipomatous hypertrophy of IAS, mistaken for atrial mass
Coumadin ridge, prominent muscle ridge between LAA and atrial insertion of LUPV
Moderator band, mistaken for mass
Lambl excrescences, mistaken for mass
Valve strands, mistaken for lesion
Prosthetic valve sutures, mistaken for lesion
Pericardial fat, mistaken for mass
Pulmonary parenchyma, mistaken for pleural effusion
Hiatal hernia, mistaken for mass
TEE tomographic views: exact views vary relative to the position of the (3)
heart
esophagus
diaphragm
pericardial effusion (if blunt chest trauma) usually associated with either:
cardiac contusion
great vessel tear
myocardial tear
after heart injury (blunt chest trauma) how does pericardial effusion fluid look? Does it look different?
it is bloody
how does tamponade appear on echo?
small right sided chambers
respiratory variation
diastolic collapse of RA and RV
patient just had tamponade surgery… follow up echo will be used to evaluate
if PE has resolved… also if any complications like pericardial restriction
pneumothorax associated with
rib fractures
pneumothorax can be seen in what exam?
x-ray
this can actually shift the heart position making an echo pretty difficult
pneumothorax
a cardiac contusion is a
bruise to the myocardium
cardiac contusion (what damages can result)
cellular injury
hemorrhage
resulting necrosis of myocardial fibers
