LIMITING CARDIAC EVALUATION IN PATIENTS WITH SUSPECTED MYOCARDIAL CONTUSION

A great deal of time and effort is spent attempting to diagnose myocar dial contusion in patients with blunt thoracic trauma. Many diagnostic protocols have been proposed in the past. However, there is no test w ith sufficient specificity to predict which patients will develop comp lications that will require therapy. Recent studies have raised the qu estion of limiting the cardiac evaluation in certain selected patients with blunt thoracic trauma. We prospectively studied the safety of li miting the cardiac evaluation in patients who were hemodynamically sta ble, had no history of cardiac disease, had a normal baseline ECG, did not require surgery or neurological observation for associated injuri es, and were less than 55 years of age. These patients represent the m ajority of patients considered at risk for myocardial contusion when m echanism is the sole criterion These patients were simply admitted for 24 hours of continuous cardiac monitoring. No patient developed any c omplications of myocardial contusion requiring therapy. We conclude th at it is safe to Limit the cardiac evaluation in this group of patient s.