Objective: In blunt chest trauma, the right ventricle is more vulnerable th
an the left. The purpose of this study was to determine whether recording V
4R in patients with blunt chest trauma would provide additional useful info
rmation to that already obtained from the standard 12-lead electrocardiogra
m (ECG).
Methods: Forty-five patients with blunt chest trauma and 40 unmatched contr
ol subjects without blunt chest trauma had standard 12-lead ECG and right p
recordial leads recorded. The ECGs were read blindly by three physicians.
Results: Patients with chest trauma were distinguishable from controls on t
he basis of the left-sided ECGs (odds ratio, 2.9; 95% confidence interval,
1.71-4.90), This was not the case using V4R (odds ratio, 1.23; 95% confiden
ce interval, 0.59-2.0).
Conclusion: Patients with a significant mechanism and physical findings of
blunt chest trauma were more likely than controls to have an abnormal EGG.
They were not more likely to have abnormalities in V4R, We recommend that a
12-lead EGG, but not V4R, be routinely obtained on these patients.