BLUNT CARDIAC INJURY - A 10-YEAR INSTITUTIONAL REVIEW

A 10 year review of all blunt cardiac injuries(N=70) at a single traum a institution was conducted. The majority of patients were diagnosed o n the basis of elevated myocardial band fraction of creatine kinase (C K-MB), ST/T wave changes or arrhythmias. The presence of CK-MB elevati on was not predictive of arrhythmias, cardiac complications, inotrope requirement, or mortality. The presence of ECG abnormalities or arrhyt hmias was also not predictive of inotrope requirement or mortality. Ca rdiac complications requiring treatment occurred in 26 per cent (N=18) of patients. Patients requiring inotropes (N=12, 17 per cent) had hig her Injury Severity Scores (ISS), longer times from injury to emergenc y, and higher mortality rates, than those not requiring them. Patients who died (N=10) had a higher ISS, lower Revised Trauma Score, and a m ore frequent need for inotropes. Only three deaths were directly attri butable to the cardiac injury. Myocardial contusion is an injury often of little clinical importance. Patients present with injuries of litt le or no consequence, severe injuries where the diagnosis is readily a pparent, or as a confounding variable in a multiply injured patient. E arly use of transthoracic echocardiography is advocated. (C) 1997 Else vier Science Ltd.