Role of echocardiography in the evaluation of blunt or penetrating thoracic trauma

Katherine E. McLean, Fiancea A. DeRook, John Spcrtus, Terese Tognazzi-Evans, Gregory Jurkovich, Keith A. Coroess

Research output: Contribution to journalArticlepeer-review


Transthoracic cchocardiography (TTE) is a useful technique in determining the presence of pericardial effusion (PE) or tamponade in patients who have acutely suffered blunt or penetrating chest trauma. The puipose of this study is to correlate the physical examination (EX) and clinical pre-test probability (FTP) with the TTE findings at a level 1 trauma center. Methods: Over a 16 month period from October 1994 to February 1996, 76 consecutive patients (64 men/ 12 women; mean age 34 ± 11 years) were prospcclively evaluated cmcrgcntly by TTE. Prior to TTE, the referring physician (ER or surgery MD) completed a survey on the EX and the PTP for a positive TTE. A positive TTE is defined as an abnormal amount of fluid in the pericardium which may or may not affect cardiac hemodynamics. Exclusion criteria included patients who had had cardiopulmonaiy resuscitation, emergent surgery prior to TTE, and transesophageal echocardiography for evaluation of aortic injury. Results: Of the 76 patients, 23 had major blunt trauma and 53 had penetrating trauma. 10 patients had positive TTE showing a PE, 2 of these 10 had findings consistent with tamponade. Of the 10, 4 patients had blunt trauma and 6 had penetrating trauma. Of the 2 with tamponade, 1 had blunt and 1 had penetrating trauma. TTE-(66) TTE-(10) P value systolic BP 132(44-189) 107(44-166) NS diastolic BP 79(0-109) 66(0-109) NS pulse 95(55-160) 113(90-139) 0.015 Pulse was significantly higher in TTE(-4), but overlap with TTE(-) made EX diagnostically unhelpful. There was no correlation between PTP and likelihood of having a TTE(+). 6 of 10 patients went directly to the operating room for pericardial window and further exploration, 3 of 10 were observed and discharged, and 1 died from noncardiac complications. Conclusions: This is the first prospective, consecutive series of trauma patients to correlate EX, PTP and TTE in blunt and penetrating thoracic injury. The number of PE found in the blunt trauma group was higher than previously reported and indicates that patients with blunt trauma should be evaluated by TTE and observed in the event lhat tamponade develops.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Issue number4
StatePublished - Dec 1 1997
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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