Chest trauma: Evaluation by two-dimensional echocardiography

Patients with either blunt or penetrating chest injuries may develop a variety of cardiac complications. The studies of 76 patients with suspected cardiac injury obtained over a 30-month period were reviewed in order to determine how frequently and in what manner two-dimensional echocardiography (2DE) is of value in the assessment of such patients. Thirty-nine patients had blunt trauma (group I), and 37 had penetrating trauma (group II). The 2DE findings in group I were: no visible abnormality in 19, pericardial effusions in six, and wall motion abnormalities in two; the studies were technically inadequate in six. In group II patients, the 2DE findings were: no visible abnormality in 14, pericardial effusions in 12, wall motion abnormalities in three, and unusual abnormalities such as foreign body or intrathoracic air in three; the studies were technically inadequate in four. This study shows that satisfactory 2DE can be performed in up to 87% of unselected patients who sustain chest injuries and does provide clinically valuable information that cannot be easily obtained by other noninvasive tests. In this series, 2DE was of greatest value in the detection of pericardial effusions that were present in 27% and of unusual abnormalities including intrathoracic air and foreign bodies such as a bullet.