Document Detail

The asymptomatic patient with suspected myocardial contusion.
MedLine Citation:
PMID:  2252127     Owner:  NLM     Status:  MEDLINE    
Diagnostic criteria and guidelines for hospital admission for suspected myocardial contusion (MCC) remain unclear. This study defines and examines the clinical sequelae of patients admitted with a suspicion of MCC. Criteria for observation following isolated, minor blunt chest trauma are suggested. Hospital and trauma registry records of patients admitted over a 33-month period with suspected MCC were reviewed. Conventional evaluation criteria, cardiac-related complications, and associated injuries were analyzed for 524 patients. Twenty-eight cardiac-related complications occurred in 27 of 524 patients (5%). These complications included 23 dysrhythmias, 3 infarctions, and 2 pericardial effusions. There were 23 patients with abnormal admission electrocardiograms and 4 with normal ones. Of the latter, one patient developed dysrhythmia 4 hours after admission, and three had other major multi-system injuries requiring admission to the intensive care unit. The overall incidence of cardiac-related complications in minimally injured patients was 0.1%. There were no complications in patients with isolated chest wall contusions, a normal admission electrocardiogram, and a normal rhythm at 4 hours. There was no significant association between creatine phosphokinase isoenzymes or echocardiogram and cardiac-related complications. The complete absence of significant cardiac sequelae in patients with isolated chest wall contusion, normal admission and 4-hour electrocardiograms, and no other associated major injuries suggests that these patients need not be admitted.
M B Foil; R C Mackersie; S R Furst; J W Davis; M S Swanson; D B Hoyt; S R Shackford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  160     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-15     Completed Date:  1991-01-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  638-42; discussion 642-3     Citation Subset:  AIM; IM    
Department of Surgery, University of California, San Diego Medical Center.
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MeSH Terms
Contusions / diagnosis*,  epidemiology,  etiology
Creatine Kinase / blood
Heart Injuries / diagnosis*,  epidemiology,  etiology
Injury Severity Score
Risk Factors
Thoracic Injuries / complications*
Wounds, Nonpenetrating / complications*
Reg. No./Substance:
0/Isoenzymes; EC Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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