Cardiac Trauma (Penetrating and Blunt) and Anesthetic Issues

Abstract

Patients with blunt or penetrating trauma can require anesthesia and surgery for cardiac injury in the face of noncardiac trauma, or can require anesthesia and surgery for noncardiac injury in the face of cardiac trauma. The true incidence of blunt cardiac trauma is not known, and estimates vary widely with different diagnostic criteria. The diagnosis of traumatic cardiac injury, particularly bluntcardiac injury, may be difficult even with a wealth of available diagnostic tools. Both blunt and penetrating trauma can result is a variety of injuries to cardiac structures. Manifestations of acute traumatic cardiac injury can differ from the clinical manifestations ofsimilar defects in the chronic setting on physical examination, radiography, and in symptomatology. There may be sequelae of traumatic injury which persist, or which may not become apparent for some period of time. Inexpensive, easily-interpreted laboratory criteria for reliably diagnosing cardiac trauma remain. Preexisting cardiacdisease and acute myocardial injury can complicate appropriate resuscitation from massive noncardiac injury. In general, and if unassociated with major noncardiac injuries, patients with cardiac injury be managed with low perioperative mortality.