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Table 1 Review of Myocardial Contusion Evaluation in Blunt Thoracic Trauma

From: Dissection of the left main coronary artery after blunt thoracic trauma: Case report and literature review

Author/Journal Number of patients Number of cardiac complications Conclusions
Baxter, et al. [19]
Retrospective 6 year review of all patients with blunt chest trauma
280 35 patients with myocardial contusion (MCC)
7 complications
2 deaths
* 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. [3]
Retrospective 4-year review of all patients with high-risk blunt chest trauma
359 107 MCC
14 dysrhythmias
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 [20]
Retrospective 6-year review of patients with blunt thoracic trauma
336 19 *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 [21]
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. [22]
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.