Abstract
There has been difficulty in the appropriate determination of blunt cardiac injury (BCI) related to blunt thoracic trauma (BTT). The aim of this study is to assess BCI and the effectiveness of diagnostic tests in BTT in patients admitted to the emergency department (ED). Eighty-eight patients with suspected myocardial injury in BTT were enrolled. The diagnostic criteria for BCI were: elevation of troponin I, arrhythmia requiring treatment, unexplained low voltage on electrocardiography (ECG), unexplained hypotension requiring vasopressor, cardiogenic shock requiring inotropes, and transthoracic echocardiographic (TTE) findings suggestive of BCI. Patients with arrhythmia in the medical history, congestive heart failure, ischemic heart disease, history of cardiac surgery, and those <16 years of age were excluded. The BCI rate was 25% in thoracic injuries. The sensitivity and specificity of troponin I, creatine kinase-MB fraction (CK-MB)/creatine kinase (CK) ratio, ECG, and CK-MB/CK ratio plus ECG were 68% and 100%, 50% and 53%, 54.5% and 72%, and 59% and 33%, respectively. Frequency of palpitation, initial CK-MB levels, initial heart rate, frequency of pulmonary contusion, abnormal ECG, and mortality rate were significantly highe...Continue Reading
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