Radiology, Vol 160, 91-94, Copyright © 1986 by Radiological Society of North America
Posttraumatic cardiac dysfunction: assessment with radionuclide ventriculography
RC Rosenbaum and GS Johnston
The authors studied 54 patients with multisystem trauma, including blunt
chest injury, using combined dynamic first-pass and
electrocardiographically (ECG) gated radionuclide ventriculography (RNV) to
evaluate for posttraumatic myocardial dysfunction. Twenty-six of 54 (48%)
patients had abnormalities of ventricular wall motion. The ventricular
dysfunction was confined to the right ventricle in 92% of cases. In
general, abnormalities consisted of right ventricular dilatation and
diffuse hypokinesia, although in seven cases there were localized
wall-motion abnormalities. The right ventricular ejection fraction of those
patients with wall-motion abnormalities was significantly lower than those
with normal studies. Left ventricular ejection fraction did not differ
significantly between these groups. ECG changes were not associated with
the cardiac dysfunction demonstrated scintigraphically, nor was there a
relationship between the number or type of extrathoracic or thoracic
injuries demonstrated by RNV. Follow-up studies obtained in 15 cases showed
a significant overall improvement in cardiac function by 3 weeks after
injury. Combined first-pass and ECG-gated RNV is useful for the
identification and follow-up of patients with posttraumatic cardiac
dysfunction.
