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Echocardiogram in sternal fracture.
Y Wiener1, B Achildiev, T Karni
1Department of General Surgery B, Assaf Harofeh Medical Center, Zeriffin, Israel. wiyiya@inter.net.il
The American Journal of Emergency Medicine
|September 14, 2001
Summary
Echocardiogram (ECHO) is vital for diagnosing myocardial contusion in sternal fracture patients. "Benign" pericardial effusions detected by ECHO do not require prolonged observation.
Area of Science:
- Cardiology
- Trauma Surgery
- Emergency Medicine
Background:
- Sternal fractures often result from blunt chest trauma.
- Cardiac complications following sternal fractures require accurate diagnosis.
Purpose of the Study:
- To assess the utility of electrocardiogram, creatine kinase MB isoenzyme, and echocardiogram (ECHO) in diagnosing myocardial contusion in patients with sternal fractures.
- To evaluate the incidence and significance of pericardial effusion in this patient population.
Main Methods:
- Retrospective review of 50 consecutive patients with sternal fractures due to blunt chest trauma.
- Analysis of cardiac test results including electrocardiogram, creatine kinase MB isoenzyme, and echocardiogram (ECHO).
Main Results:
- 22% of patients had abnormal cardiac tests; only 6% had symptomatic myocardial contusion.
- Echocardiogram (ECHO) identified myocardial contusion in one case where other tests were normal.
- 22.5% of ECHO studies revealed pericardial effusion, often without clinical significance or association with injury severity.
Conclusions:
- Echocardiogram (ECHO) is a valuable diagnostic and triage tool for sternal fracture patients with associated injuries.
- Patients with "benign" pericardial effusion identified by ECHO can be discharged once medically stable.