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Blunt chest trauma: a clinical chameleon
  1. Kaveh Eghbalzadeh1,
  2. Anton Sabashnikov1,
  3. Mohamed Zeriouh1,
  4. Yeong-Hoon Choi1,
  5. Alexander C Bunck2,
  6. Navid Mader1,
  7. Thorsten Wahlers1
  1. 1 Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
  2. 2 Department of Radiology, University Hospital Cologne, Cologne, Germany
  1. Correspondence to Dr Anton Sabashnikov, Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne 50937, Germany; a.sabashnikov{at}


The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury. However, on admission to emergency departments symptoms might be missing or may not be clearly associated with the injury. Accurate diagnostics and early management in order to prevent serious complications and death are essential for patients suffering a BCT. Optimal initial diagnostics includes echocardiography or CT, Holter-monitor recordings, serial 12-lead electrocardiography and measurements of cardiac enzymes. Immediate diagnostics leading to the appropriate therapy is essential for saving a patient’s life. The key aspect of the entire management, including diagnostics and treatment of patients with BCT, remains an interdisciplinary team involving cardiologists, cardiothoracic surgeons, imaging radiologists and trauma specialists working in tandem.

  • cardiac imaging and diagnostics
  • aortic and arterial disease

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  • Contributors KE wrote the manuscript. All authors contributed to the final manuscript, provided suggestions, prepared and revised the manuscript. KE, AS, MZ, Y-HC, ACB, NM, TW performed literature search and discussed the data. ACB was responsible for the imaging data collection and interpretation.

  • Competing interests None declared.

  • Ethics approval The ethics committee of the University Department of Cologne approved the manuscript design.

  • Provenance and peer review Commissioned; externally peer reviewed.