chest trauma Q -

[ArchivalUser]

TAC

That is a different situation That was not mentioned in the question. If it was mentioned I would have said ECG for sure. :o)
When things are not mentioned, I tend to assume they are normal. That is why I didnt go for ekg.
But I have to admit that my thiking can be kinda twisted sometimes. LOL


TAC

[ArchivalUser]

aditi

So since nothing has been mentioned abt the pulse rate and rhythm of the patient and given the fact the arrhythmias are the commonest complication following cardiac contusion,I think it is logical to think of an ECG as the best screening test!
What do you say??

[ArchivalUser]

TAC

Aditi, now that it was said that arrhythmias are the commonest complication following cardiac contusion, it sounds reasonable to me. :o) Before it was mentioned, i didnt know about that fact. :o)

TAC

[ArchivalUser]

hooch !@!@

Mechanism of cardiac contusion

Contusion results from compression of myocardium b/w sternum in front and the bodies of thoracic vertebrae behind.
Right ventricle constitutes the major part of heart anteriorly and takes the brunt of the blow.

The left ventricle -posterior may or may not be involved depending on the severity.

Blood extravasates into the myocardial tissue , resulting in the progressive loss of the ventricular function and culminating in the decreased cardaic output .

Patient initially may be normotensive , and it takes 8-24 hr of cardiac output to affected.

MUGA Scan

It is for calculation of ejection fraction and assessing degree of contractility qualitatively.

Labelled erythrocytes are injected intravenously and allowed to mix well with the blood. The heart is then imaged with a gamma-camera. Several hundred cardiac cycles are averaged to provide a clear image of the heart throughout the cycle.

Muga scan diagnoses myocardial contusion unequivocally.

[ArchivalUser]

aditi

As far as i understand,MUGA scanning are particularly useful for the left ventricular function.It measure EF and assesses any part of the left ventricluar wall which contracts abnormally.As you mentioned that right ventricle takes the brunt of the blow,MUGA scan shouldn't be as useful...May be i am wrong..any other comments?

[ArchivalUser]

ankur

I would think that MUGA can be used for either ventricle,not necessarily the left.

[ArchivalUser]

aditi

well the source of my question is NMS surgery...and it said MUGA scan is not useful in evaluating cardiac contusion in blunt trauma patients...So where does it leave us??

[ArchivalUser]

hooch !@!@


Infact the source of my explaination is from NMS review,
although not directly mentioned but it states tht MUGA can be used for either ventricle.

[ArchivalUser]

aditi

Agreed MUGA can be used for both ventricles,but the question is whether it is the gold standard for diagnosing cardiac contusion??

[ArchivalUser]

hooch !@!@


Yes the book i mentioned says so..