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[Myocardial contusions in closed thoracic injuries: a prospective study]
O Vincent-Mansoor1, D Joyon, J E Bazin
1Département d'Anesthésie-Réanimation, CHRU, Clermont-Ferrand.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1991
Summary
Diagnosing myocardial contusion after blunt chest trauma is challenging. Two-dimensional echocardiography (2D-EC) offers reliable bedside assessment, surpassing physical exams and enzyme assays in accuracy for detecting cardiac injury.
Area of Science:
- Cardiology
- Trauma Medicine
- Diagnostic Imaging
Background:
- Blunt chest trauma can cause myocardial contusion, a cardiac injury requiring accurate diagnosis.
- Assessing the accuracy of various diagnostic tools for myocardial contusion is crucial for effective patient management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of multiple investigations for myocardial contusion in patients with blunt chest trauma.
- To compare the effectiveness of thallium-201 scintigraphy with other cardiac assessment methods.
Main Methods:
- Inclusion of patients aged 18-50 with blunt chest trauma requiring ICU admission.
- Comprehensive cardiac assessment including physical examination, ECG, chest X-ray, enzyme assays, 2D-echocardiography (2D-EC), and thallium-201 scintigraphy.
- Diagnosis of myocardial contusion based on thallium-201 scintigraphy findings.
Main Results:
- Two-dimensional echocardiography (2D-EC) provided the most valuable data, identifying pericardial effusions in one-third of patients.
- Physical examination, enzyme assays, and chest X-rays showed limited diagnostic value for myocardial contusion.
- Thallium-201 scintigraphy diagnosed myocardial contusion in 50% of cases, but 2D-EC offered comparable reliability at the bedside.
Conclusions:
- Two-dimensional echocardiography (2D-EC) is a reliable and accessible tool for diagnosing myocardial contusion in blunt chest trauma patients.
- Routine long-term follow-up is likely unnecessary as patients remain asymptomatic.
- 2D-EC is advantageous due to its bedside applicability compared to other methods.