Acute and long-term clinical significance of myocardial contusion following blunt thoracic trauma: results of a prospective study.
BACKGROUND
The clinical significance of myocardial contusion (MC) following blunt thoracic trauma is still unknown. Accordingly, in this prospective study in a regional trauma center we investigated the acute and long-term clinical significance of MC.


METHODS
One-hundred eighteen patients with manifest or suspected blunt thoracic trauma were evaluated for cardiac injury. Initial assessment was based on results of electrocardiographic, echocardiographic, and serial enzyme measurements. A follow-up (FU) assessment conducted at 3 and 12 months, respectively, was performed using electrocardiography, echocardiography, and a bicycle ergometry exercise test.


RESULTS
Of the 118 patients in the total sample, 67 (56.8%) required admission to the surgical intensive care unit (SICU) because of the severity of their noncardiac injuries. Fourteen patients of the total sample (11.8%) were diagnosed with MC and 13 of these (92.9%) belonged to the intensive care admissions, thus representing an incidence of 19.4% in this patient group. During the hospitalization period none of the patients with MC experienced acute cardiac complications. Eighty-six patients (72.0%) were assessed at FU. No new pathologies were found except in one patient. Exercise testing revealed no ECG abnormalities and none of the patients experienced limitations on the bicycle ergometer due to a cardiac cause.


CONCLUSIONS
The incidence of 19.7% of MC in our patients with blunt chest injury requiring intensive care treatment indicates that this condition is frequent in polytraumatized patients. Outcome and prognosis in patients with MC is favorable and, thus, routine cardiac work-up is not indicated. Specific diagnostic and therapeutic measures should be limited to cases where cardiac complications develop.
Lindstaedt
Michael
M
Department of Cardiology, University Hospital 'Bergmannsheil', Bochum, Germany. michael.lindstaedt@ruhr-uni-bochum.de
Germing
Alfried
A
Lawo
Thomas
T
von Dryander
Stefan
S
Jaeger
Detlev
D
Muhr
Gert
G
Barmeyer
Juergen
J
D000328:Adult; D016009:Chi-Square Distribution; D003402:Creatine Kinase / Q000097:blood; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D013898:Thoracic Injuries / Q000150:complications*; D014949:Wounds, Nonpenetrating / Q000150:complications*
D007527:Isoenzymes; D003402:Creatine Kinase