MYOCARDIAL DYSFUNCTION IN POLYTRAUMA

Trauma remains one of the leading causes of mortality worldwide, particularly among the young population. A significant number of people die within the first 48 hours due to acute cardiovascular pathology. Cardiac injury is a significant predictor of adverse outcomes following multiple trauma, associated with poor prognosis and prolonged hospitalization. Systemic elevation of cardiac troponin levels is linked to survival, the severity of trauma, and catecholamine consumption in patients after multiple trauma. Clinical signs of the so-called "commotio cordis" include arrhythmias, such as ventricular fibrillation and sudden cardiac arrest, as well as wall motion abnormalities. In trauma patients with inadequate hypotension and a lack of adequate response to fluid therapy, the possibility of cardiac injury should be considered. Therefore, a combination of electrocardiography, echocardiography, and the systemic determination of cardiomyocyte injury markers, such as troponin, appears to be an appropriate diagnostic method for identifying cardiac dysfunction after trauma. However, the mechanisms of post-traumatic cardiac dysfunction continue to be actively studied. The aim of this review is to discuss cardiac injury following trauma, focusing on the mechanisms of post-traumatic cardiac dysfunction related to inflammation and complement activation. The review illustrates the causal relationship between cardiac dysfunction and blunt chest trauma, multiple trauma, and hemorrhagic shock.