Analysis of ECG findings in patients with traumatic lung injury

The aim of this thesis study is to compare the Thorax Trauma Severity Score (TTSS) with ECG findings and laboratory results in patients diagnosed with thoracic trauma who do not have a clinically evident cardiac injury. This prospective and observational study included patients over the age of 18 who were diagnosed with thoracic trauma based on physical examination and underwent thoracic computed tomography (T-CT) imaging. Patients with detected cardiac injury during clinical follow-up or those with a history of ischemic heart disease were excluded from the study. ECG samples were obtained from all patients, and Hs Troponin I and lactate levels were measured. The Thorax Trauma Severity Score (TTSS) was calculated for each patient. Patients were categorized into groups based on their TTSS ranges: Group I (TTSS: 0-5), Group II (TTSS: 6-10), and Group III (TTSS: 11-15). ECG findings and laboratory results were compared according to the patients' TTSS levels. Troponin and lactate levels in Group III (TTSS ≥ 11) patients were found to be higher than those in Group I and Group II (p=0.011). In patients who developed pulmonary contusion, troponin (p=0.045) and lactate (p=0.003) levels were significantly higher than those without contusion. When all patients were evaluated collectively, the most common ECG findings were sinus tachycardia, low voltage, right bundle branch block (RBBB), prolonged QTc, negative T-wave in lead DIII, and negative T-waves in V3R-V6R on right-sided ECG. In patients with TTSS ≥ 11, low voltage, RBBB, prolonged QTc, negative T-wave in DIII, and negative T-waves in two consecutive leads between V1-V6 were observed more frequently. In cases of pulmonary contusion, ST-segment elevation in lead aVR was the most common finding. Low voltage and RBBB were most frequently seen in hemopneumothorax and pulmonary contusion. In pneumothorax, RBBB, left axis deviation, and prolonged QTc were among the common findings In thoracic trauma, blood lactate and troponin levels increase as the TTSS increases. Similarly, the prevalence of ECG findings increases with higher TTSS. Pulmonary contusion, pneumothorax, and hemopneumothorax resulting from trauma cause ECG changes. These changes may be due to the mechanical effect of space-occupying lesions on the heart, as seen in pneumothorax and hemopneumothorax. Additionally, they may be related to right heart overload caused by an acute increase in pulmonary artery pressure, as seen in pulmonary contusion. Keywords: Thoracic trauma, ECG, Thorax trauma severity score, Pulmonary contusion, Hemopneumothorax, Pneumothorax, Troponin I, Lactate