Electrocardiographic ST-segment elevation in the trauma patient: acute myocardial infarction vs myocardial contusion.
The diagnosis of myocardial contusion in the setting of blunt trauma engenders much discussion and controversy-partly because of the lack of a gold standard for its identification other than histologic findings at autopsy. Furthermore, blunt cardiac trauma represents a spectrum of disorders ranging from transient electrocardiographic change to sudden death from myocardial rupture; hence, no single terminology exists to define such a wide range of scenarios. Here, we present 2 cases of electrocardiographic ST-segment elevation after high-speed motor vehicle crashes resulting in numerous injuries, including blunt chest trauma. Both patients demonstrated electrocardiographic ST-segment elevation, resulting from myocardial contusion and acute myocardial infarction.
Plautz
Claire U
CU
Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
Perron
Andrew D
AD
Brady
William J
WJ
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D002637:Chest Pain / Q000209:etiology; D003288:Contusions / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004635:Emergency Medicine / Q000379:methods; D006335:Heart Injuries / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*