One-year follow-up and convalescence evaluated by nuclear medicine studies and 24-hour holter electrocardiogram in 11 patients with myocardial injury due to a blunt chest trauma.
BACKGROUND
There are few reports on long-term convalescence with regard to cardiac injury caused by blunt chest trauma. Nuclear medicine study of the heart (NMSH) in the early stages of injury is reportedly superior to detect the correlation between injury and fatal arrhythmia. Therefore, we prospectively performed NMSH and Holter electrocardiogram (ECG) in the early and chronic stages for a cardiac injury patient, and we longitudinally examined the recovery process and the occurrence of fatal arrhythmia.


RESULTS
A total of 202 patients with blunt chest trauma were admitted to our hospital between April 2006 and January 2007. Of 65 patients who were diagnosed with cardiac injury by ECG, a myocardial enzyme, or cardiac ultrasonography, 11 were enrolled in this study because they agreed to outpatient visiting for regular examinations for 1 year. NMSH showed positive findings in 6 of the 11 patients in the acute period of <1 month. Twelve months later, five patients improved but still exhibited protracted cardiac damage without complete recovery. Among the six patients in whom NMSH showed positive findings, Holter ECG indicated an abnormal finding in two patients in the acute period and in four patients in the chronic period, and detected one patient with a nonsustained ventricular tachycardia in the chronic period.


CONCLUSIONS
Cardiac injuries may exacerbate cardiac functions and lead to fatal arrhythmia during the chronic period. Therefore, evaluating recovery for at least 12 months after myocardial damage is necessary to prevent sudden cardiac death.
Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. mariam@is.icc.u-tokai.ac.jp
Mari
M
Amino
Koichiro
K
Yoshioka
Seiji
S
Morita
Shinichi
S
Iizuka
Hiroyuki
H
Otsuka
Rie
R
Yamamoto
Hiromichi
H
Aoki
Toru
T
Aizawa
Yuji
Y
Ikari
Seiji
S
Nasu
Kenji
K
Hatakeyama
Misako
M
Iino
Itsuo
I
Kodama
Sadaki
S
Inokuchi
Teruhisa
T
Tanabe
D000328:Adult; D001145:Arrhythmias, Cardiac; D015331:Cohort Studies; D003289:Convalescence; D016757:Death, Sudden, Cardiac; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D009683:Nuclear Medicine / Q000379:methods; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000401:mortality; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
D019275:Radiopharmaceuticals