|Author/Journal||Number of patients||Number of cardiac complications||Conclusions|
Baxter, et al. |
Retrospective 6 year review of all patients with blunt chest trauma
35 patients with myocardial contusion (MCC)|
* Complications of MCC manifest within 12 hours.|
* Patients with suspected MCC should have cardiac monitor and enzyme monitoring for 24 hours or until hemodynamically and electrically stable.
* Patients with known coronary artery disease should have monitoring until hemodynamically stable and a myocardial infarction is ruled out.
* Echocardiogram is helpful to further evaluate MCC.
Biffl, et al. |
Retrospective 4-year review of all patients with high-risk blunt chest trauma
3 cardiogenic shock
with 2 deaths
* Cardiac enzymes (CPK, CKMB) have no useful role in the evaluation of patients with myocardial contusion.|
* Risk factors associated with complications from MCC include age > 55, abnormal admission EKG (except sinus tachycardia), absence of chest pain, head injury with GCS < 8, and pelvic fracture.
Cachecho, et al |
Retrospective 6-year review of patients with blunt thoracic trauma
*Young patients with minor blunt thoracic trauma and minimally abnormal EKG do not benefit from cardiac monitoring.|
* Evaluation of MCC should not be pursued in hemodynamically stable patients.
Karalis, et al |
12-month prospective evaluation of patients admitted with blunt thoracic trauma
|105||8||* Only patients who have complications from MCC benefit from echocardiogram. Transesophageal echo may be beneficial if thoracic trauma limits the quality of a trans-thoracic study.|
Adams, et al. |
12-month prospective evaluation of patients with blunt thoracic trauma
|44||2 acute myocardial infarctions||Cardiac troponin I accurately detects cardiac injury after blunt chest trauma.|