Troponin Elevation is not a Strong Predictor of Abnormalities on Echocardiography Following Blunt Trauma to the Chest Wall

The evidence base for echocardiography in blunt chest trauma remains an area of ongoing investigation. Based on first principles, contemporary real world practice mandates echocardiography testing in patients with cardiac specific biomarker (troponin (TnI)) elevation. Prediction of echocardiogram abnormalities based on TnI elevation has not been formally evaluated in this patient category. Methods: Retrospective analysis of all patients presenting with blunt chest trauma, without established underlying cardiac disease, over a calendar year, included in a trauma database in our tertiary hospital. All patient presentations with chest trauma were reviewed and TnI values and echocardiograms independently audited. Results: 337 patients presented to our tertiary trauma centre secondary to blunt force chest trauma during a full calendar year.Tabled 1TnI AssessmentNumber of Trauma Presentations (%)Number with Echocardiograms (%)Number Abnormal Findings on Echocardiography (%)Positive55 (16)24 (44)4 (17)Negative56 (16)15 (27)1 (7)Not assessed226 (67)17 (8)0 (0) Open table in a new tab There was a trend towards abnormal echocardiograms in the troponin positive group however this was not statistically significant utilising Fishers exact test (p > 0.1). Conclusion: In patients presenting to a major trauma centre with blunt force trauma to the chest wall, raised cardiac troponin was not a strong predictor of abnormalities on echocardiography.