[Myocardial contusion after blunt thoracic trauma: possible indication for rhythm observation].
A 65-year-old man had a pneumohaemothorax and fractured ribs after an automobile accident. Troponine concentrations were normal and the initial electrocardiographic abnormalities resolved within 24 hours. A 46-year-old man who was also in an automobile accident developed a seat-belt haematoma and lung oedema. Troponine concentrations were increased, the electrocardiogram was abnormal and transthoracic ultrasound revealed severe myocardial contusion. After a few weeks of treatment, both patients were discharged without cardiac complications. It is clinically important to identify patients at risk of developing myocardial contusion following blunt thoracic trauma. A combination oftroponine and electrocardiography is necessary to differentiate between risk categories. Echocardiography has a role in haemodynamically unstable patients and whenever the clinical condition of the patient deteriorates. A structured approach to screening and evaluation, as presented in an algorithm, can be used as a guide in the follow-up of patients with myocardial contusion.
Oosterloo
M
M
Universitair Medisch Centrum Groningen, Groningen. m.oosterloo@nijsmellinghe.nl
Nieuwland
W
W
Zijlstra
F
F
D000063:Accidents, Traffic; D000368:Aged; D003288:Contusions / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013898:Thoracic Injuries / Q000150:complications / Q000175:diagnosis*; D014336:Troponin / Q000032:analysis; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis*
D014336:Troponin