Journal of Trauma and Injury

Original Article

Effects of Trauma-Related Shock on Myocardial Function in the Early Period Using Transthoracic Echocardiography: Dae Sung Ma; J Trauma Inj. 2021;34(2):119-125. Published online June 30, 2021; DOI: https://doi.org/10.20408/jti.2021.0041

Abstract PDF: Purpose
The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings.
Methods
We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016.
Results
The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group.
Conclusions
This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.; Summary

Case Report

Delayed Diagnosis of Traumatic Rupture of Anterior Papillary Muscle of Tricuspid Valve; Importance of Trans-Esophageal Echocardiogram in the Evaluation of Major Blunt Chest Trauma: Ryan Bylsma, Mustafa Baldawi, Bruce Toporoff, Matthew Shin, Meghan Cochran-Yu, Davinder Ramsingh, Purvi Parwani, David G. Rabkin; J Trauma Inj. 2021;34(2):136-140. Published online June 4, 2021; DOI: https://doi.org/10.20408/jti.2020.0060

Abstract PDF: We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.; Summary

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