Key result
CMR detects anteroseptal cardiac contusion after echo and CT fail to locate the injury.
Why the study?
Does cardiac magnetic resonance imaging improve the qualitative diagnosis of blunt cardiac injury in a patient with cardiac tamponade?
Case Report (n=1)
Does cardiac magnetic resonance imaging improve the qualitative diagnosis of blunt cardiac injury in a patient with cardiac tamponade?
Cardiac magnetic resonance imaging may be useful in evaluating non-operative management of blunt cardiac injury when other imaging modalities fail.
May support CMR for blunt cardiac injury missed by echo/CT; leaves open prospective validation before wider use.
Case: A 47-year-old man was admitted after a car collision in shock with cardiac tamponade. After his circulation was stabilized by pericardial drainage, we treated him conservatively. Abnormal laboratory data and initial electrocardiogram (ECG) were suggestive of myocardial injury. However, echocardiography and cardiac computed tomography could not reveal the cause of the tamponade or the site of cardiac injury. ECG-gated cardiac magnetic resonance images were acquired. Outcome: The cardiac magnetic resonance black-blood T2-weighted images showed hyperintense signals in the interventricular septum, whereas the late gadolinium enhancement images showed no enhancement in this region. We could accurately diagnose cardiac contusion of the anteroseptal area, which would explain the initial ECG abnormality seen in this patient. Conclusion: Cardiac magnetic resonance imaging may be especially useful in the evaluation of non-operative management of blunt cardiac injury and could explain the initial ECG abnormality seen in our patient.
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Kaneda et al. (2015) conducted a case report in Blunt cardiac injury (n=1). Cardiac magnetic resonance imaging vs. Echocardiography and cardiac computed tomography was evaluated on Qualitative diagnosis of blunt cardiac injury. Cardiac magnetic resonance imaging accurately diagnosed an anteroseptal cardiac contusion in a 47-year-old man after echocardiography and computed tomography failed to reveal the injury site.
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