RECENT ADVANCES IN THE MANAGEMENT OF NON-PENETRATING HEART TRAUMA: A REVIEW OF DIAGNOSTIC AND THERAPEUTIC PRACTICES

• DOI: https://doi.org/10.22533/at.ed.1594622427064

• Palavras-chave: Non-penetrating cardiac trauma; clinical diagnosis; cardiac biomarkers

• Keywords: Non-penetrating cardiac trauma; clinical diagnosis; cardiac biomarkers

• Abstract:

  Objective: This study reviews recent advances in the management of non-penetrating cardiac trauma, providing insights for clinical practice and the development of future therapeutic guidelines. Methods: To employ the PubMed database, 455,170 articles were initially evaluated. A rigorous selection restricted the analysis to9articles, published between 2013 and 2024, using well-defined inclusion and exclusion criteria. This thorough review provided a comprehensive and up-to-date overview of methods of managing these traumas. Results: Initial clinical assessment, including history and clinical signs, is vital for diagnosing non-penetrating cardiac trauma. Diagnostic exams such as radiography (X-ray) and electrocardiogram (ECG) are essential. The gold standard for identifying myocardial contusion is still the post-mortem evaluation of cardiac tissue, however, the combination of ECG and troponins has shown efficacy in live diagnosis. Cardiac markers such as cTnI and cTnT along with transesophageal echocardiography (TEE) are effective in detecting myocardial injury. Thoracic computed tomography (CT) is preferred to evaluate blunt trauma. Pericardiocentesis is used to treat cardiac tamponade, with surgical intervention being considered after meticulous planning. Conclusions: This systematic review highlights the complexity of managing non-penetrating cardiac trauma, underlining the importance of a multidisciplinary approach that integrates clinical assessment, use of biomarkers and advanced imaging to guide appropriate treatment.