[Clinical and pathophysiological study of myocardial contusion].
Myocardial contusion was observed in 25 patients (7.5%) out of 333 blunt chest trauma victims. As the cause of injury, 19 patients (76%) were due to traffic accident and 12 out of 19 patients had steering wheel injuries. There were a total of 72 associated thoracic injuries, and this means 2.9 injuries for each patient. As ECG abnormalities, sinus tachycardia on admission and ST, T change in time course were mostly found in this series. Chest X-ray findings revealed the maximum value (55.2 +/- 1.3%) of CTR (cardio-thoracic ratio) on the 2nd-4th hospital days, followed the decreasing tendency. CPK-MB showed its peak on the 1st-3rd hospital days, and was nearly normalized on the 5th hospital day. There were 10 expired cases, and the mortality was 40%. Cardiac death due to cardiac tamponade or cardiogenic shock was observed in 4 cases. Ventricular function study showed 2 right ventricular dysfunction. 1 left ventricular dysfunction, and 4 biventricular dysfunction, and showed extremely poor prognosis in the biventricular dysfunction group. The cases of myocardial contusion were classified into the following 3 types by the clinical findings. Type I: ECG abnormality type 13 cases; Type II: Cardiac tamponade type 7 cases; Type III: Cardiogenic shock type 6 cases. I conclude that measuring the ventricular function is useful for the evaluation of the severity and prognosis of myocardial contusion if the blunt chest trauma victim is in shock state.
D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D002305:Cardiac Tamponade / Q000150:complications; D004562:Electrocardiography; D005260:Female; D006335:Heart Injuries / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D012253:Rib Fractures / Q000150:complications; D012770:Shock, Cardiogenic / Q000150:complications; D014949:Wounds, Nonpenetrating / Q000503:physiopathology*
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases