ACR Appropriateness Criteria® Blunt Chest Trauma-Suspected Cardiac Injury.

Journal Article

Blunt cardiac injuries range from myocardial concussion (commotio cordis) leading to fatal ventricular arrhythmias to myocardial contusion, cardiac chamber rupture, septal rupture, pericardial rupture, and valvular injuries. Blunt injuries account for one-fourth of the traumatic deaths in the United States. Chest radiography, transthoracic echocardiography, CT chest with and without contrast, and CT angiography are usually appropriate as the initial examination in patients with suspected blunt cardiac injury who are both hemodynamically stable and unstable. Transesophageal echocardiography and CT heart may be appropriate as examination in patients with suspected blunt cardiac injuries. This publication of blunt chest trauma-suspected cardiac injuries summarizes the literature and makes recommendations for imaging based on the available data and expert opinion. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Full Text

Duke Authors

Cited Authors

  • Expert Panels on Cardiac Imaging and Thoracic Imaging, ; Stojanovska, J; Hurwitz Koweek, LM; Chung, JH; Ghoshhajra, BB; Walker, CM; Beache, GM; Berry, MF; Colletti, PM; Davis, AM; Hsu, JY; Khosa, F; Kicska, GA; Kligerman, SJ; Litmanovich, D; Maroules, CD; Meyersohn, N; Syed, MA; Tong, BC; Villines, TC; Wann, S; Wolf, SJ; Kanne, JP; Abbara, S

Published Date

  • November 2020

Published In

Volume / Issue

  • 17 / 11S

Start / End Page

  • S380 - S390

PubMed ID

  • 33153551

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2020.09.012


  • eng

Conference Location

  • United States