The utility of cardiac evaluation in the hemodynamically stable patient

---

with suspected myocardial contusion. Division of [1mTrauma [m Surgery, University of Illinois College of Am-Surg. 1991 Jun. 57(6). P 373-7. Myocardial contusion following isolated blunt thoracic [1mtrauma [m (BTT) remains a diagnostic and therapeutic dilemma. To identify the presence of cardiac [m abnormality following BTT, 123 hemodynamically stable patients were prospectively evaluated with serial electrocardiograms (ECG) and cardiac [m enzymes (total CPK and CPK-MB). Gated [1mcardiac [m radionuclide angiography (MUGA) scans were performed within 48 hours following admission. Patients included in the study sustained significant thoracic trauma [m identified by physical findings or mechanism of injury. Sixty-three patients (51%) were identified with either abnormal ECG, or abnormal total CPK, CPK-MB, MUGA scan, or combination of the above. Thirty-seven patients (58.7%) manifested an ECG abnormality defined as ST-segment or T-wave abnormality. Twenty-two patients (34.9%) had total CPK value greater than or equal to 50 International Units (I.U.) or CPK-MB fractions greater than or equal to five per cent. MUGA scan was abnormal (right ventricular ejection fraction less than 40 per cent and/or wall motion abnormality) in 12 patients (19%). Eight patients with MUGA scan abnormality had normal ECG and/or normal total CPK, CPK-MB values. Evaluation of all patients up to six months revealed no mortality, malignant arrhythmias, or cardiac failure.