Association between cardiac troponin I concentrations and electrocardiographic abnormalities in dogs with blunt trauma.

OBJECTIVE: To determine whether a normal cardiac troponin I (cTnI) concentration and normal ECG on entry rule out the development of a clinically significant cardiac arrhythmia (CSCA, defined as an arrhythmia requiring anti-arrhythmic treatment) in dogs that have sustained blunt trauma. DESIGN: Prospective, observational study. Client-owned dogs were enrolled between January 2015 and November 2016. SETTING: University teaching hospital. ANIMALS: Forty-seven client-owned dogs with a history of witnessed or suspected blunt trauma within 24 hours prior to presentation to the hospital. INTERVENTIONS: On admission to the emergency service, dogs had a standard 3-lead ECG and cTnI concentration (using a veterinary point-of-care device* ) performed. Animal Trauma Triage (ATT) scores, Modified Glasgow Coma Scale (MGCS), and the details regarding the nature and timing of the injury were recorded. The patients were monitored in the ICU for a minimum of 24 hours on continuous ECG telemetry. Cardiac rhythm was monitored every hour, and any abnormalities were noted. The need for anti-arrhythmic therapy was recorded. There were no treatment interventions. MEASUREMENTS AND MAIN RESULTS: Five of 47 dogs (10.6%) developed a CSCA during hospitalization after sustaining blunt trauma. A normal entry ECG and normal cardiac troponin concentration on entry had a 100% negative predictive value (NPV) for ruling out the development of a CSCA, although a normal cardiac troponin concentration alone also had an NPV of 100%. A normal entry ECG had an NPV of 95.3%. The prognosis for survival to discharge was 89.4% in this study population (42/47 dogs). CONCLUSIONS: In dogs with blunt trauma, an entry cTnI concentration or a combination of cTnI and ECG on entry may be useful in determining which patients are at a higher risk for the development of CSCA during the first 12 to 24 hours after the trauma.

Myocardial contusion and rib fracture repair in an adult horse.

OBJECTIVE: To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse. CASE SUMMARY: A 6-year-old Warmblood gelding presented for treatment of blunt thoracic trauma. Sonographic examination of the thorax revealed a complete, mildly comminuted fracture of the left 5th rib with a fragment overlying the left atrium and coronary artery, hemothorax, and subjective left ventricular dyskinesis. Evidence of myocardial injury included atrial fibrillation, ventricular ectopy, and increased plasma cardiac troponin I concentration. The rib fracture was repaired under general anesthesia using a wire and plate technique. The atrial fibrillation converted to normal sinus rhythm coincidentally with intraoperative local infusion of mepivicaine in administration of intercostal perineural analgesia. Continuous, resting, and exercising electrocardiograms, serial cardiac troponin I concentrations and echocardiograms were used to monitor the myocardial injury. The horse was discharged after 5 days of hospitalization. Reexaminations 3 and 15 months after the initial trauma showed healing of the fracture and no evidence of myocardial sequelae. NEW OR UNIQUE INFORMATION PROVIDED: To our knowledge, this is the first documentation of the diagnosis and monitoring of myocardial injury secondary to blunt thoracic trauma, as well as surgical repair of a rib fracture in an adult horse. Rib fractures and myocardial trauma can be successfully managed in adult horses and myocardial injury should be considered in cases of thoracic trauma.

Pneumotórax e miocardite traumática em um cão / Pneumothorax and traumatic myocarditis in a dog

Cães que sofrem acidentes automobilísticos na grande maioria apresentam complicações pulmonares e da parede torácica, como contusão pulmonar, pneumotórax e miocardite traumática (FOSSUM, 2007). O pneumotórax é o acumulo de ar no espaço pleural e pode ser classificado em aberto ou fechado e pela etiologia. A miocardite traumática é um termo aplicado à síndrome de arritmias e ocorre por trauma não perfurante resultado de um impacto contra a parede do tórax e na grande maioria ocorrem taquiarritmias ventriculares (NELSON E COUTO, 2003). O objetivo deste trabalho é relatar um caso de pneumotórax e miocardite traumáticos em um cão.