Myocardial contusion.
OBJECTIVE
To utilise an evidence-based strategy to answer two clinical questions regarding myocardial contusion - How is the diagnosis made and how long does a patient require cardiac monitoring?


METHODS
Pubmed search using appropriate MeSH terminology then selection of abstracts using a predetermined criteria.


RESULTS
One meta-analysis, five descriptive reviews and thirty-two other articles were selected for detailed review.


CONCLUSIONS
Myocardial contusion is an ill-defined term for traumatic cardiac injury. "Significant blunt chest trauma" appears to be a more useful term. Normal serially performed electrocardiograms and troponin I assays over 8 hours appear to exclude this condition. When complications occur, the onset is usually within 48 hours of injury. Monitoring of patients with abnormal ECG's or troponins for at least 48 hours post injury would therefore be prudent.
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Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland.