title: Role of transesophageal echocardiography in the assessment of patients with blunt chest trauma: correlation of echocardiographic findings with the electrocardiogram and creatine kinase monoclonal antibody measurements.
abstract: OBJECTIVE
  This study was designed to evaluate the usefulness of transesophogeal echocardiography (TEE) for detecting cardiac damage after blunt chest trauma (BCT).
  
  
  BACKGROUND
  Multiple methods have been used to detect cardiac damage after a BCT, but none has been demonstrated to be sensitive, specific, and feasible enough.
  
  
  METHODS
  This multicenter prospective trial was designed to evaluate the usefulness of TEE in the assessment of patients with BCT and to compare the TEE findings with those provided by the electrocardiogram (ECG) and cardiac isoenzymes assay. One hundred seventeen consecutive patients with a significant BCT were enrolled. A TEE was performed in each patient. Serial ECGs and plasma profiles of creatine kinase (CK) and CK-monoclonal antibody (MB) were obtained.
  
  
  RESULTS
  Sixty-six (56%) patients had pathologic findings in the TEE attributed to the BCT (group A). In the remaining 51 (44%) patients the TEE was normal (group B). An abnormal ECG was more frequent in group A (59% vs 24%; p < 0.001), and the serum CK-MB peak level was also higher in group A (174 +/- 30 U/L vs 93 +/- 21 U/L; p = 0.05). Relative to pathologic TEE findings, the sensitivity and specificity of an abnormal ECG were 59% and 73% and of high CK-MB with CK-MB/CK > 5% were 64% and 52%, respectively.
  
  
  CONCLUSIONS
  We conclude that TEE can be routinely and safely performed for diagnosing cardiac injuries after a BCT and plays an important role in the evaluation and treatment of these patients. EGG and CK-MB assay are not good methods for detecting cardiac damage in this setting.
authors.affiliation: Department of Cardiology, Gregorio Marañón General Hospital, Madrid, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: García-Fernández
authors.forename: J M
authors.initials: JM
authors.lastname: López-Pérez
authors.forename: N
authors.initials: N
authors.lastname: Pérez-Castellano
authors.forename: L F
authors.initials: LF
authors.lastname: Quero
authors.forename: A
authors.initials: A
authors.lastname: Virgós-Lamela
authors.forename: A
authors.initials: A
authors.lastname: Otero-Ferreiro
authors.forename: A M
authors.initials: AM
authors.lastname: Lasara
authors.forename: M
authors.initials: M
authors.lastname: Vega
authors.forename: M
authors.initials: M
authors.lastname: Moreno
authors.forename: J A
authors.initials: JA
authors.lastname: Pastor-Benavent
authors.forename: J
authors.initials: J
authors.lastname: Bermejo
authors.forename: J
authors.initials: J
authors.lastname: García-Pardo
authors.forename: M
authors.initials: M
authors.lastname: Gil de la Peña
authors.forename: J
authors.initials: J
authors.lastname: Navia
authors.forename: J L
authors.initials: JL
authors.lastname: Delcán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D003402:Creatine Kinase / Q000097:blood*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006335:Heart Injuries / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D015601:Injury Severity Score; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D000911:Antibodies, Monoclonal; D007527:Isoenzymes; D003402:Creatine Kinase