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Traumatic myocardial dysfunction.

D P Harley, I Mena, K A Narahara

The Journal of Thoracic and Cardiovascular Surgery

|March 1, 1984

Summary

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Traumatic myocardial dysfunction is common after blunt chest trauma, often missed by standard tests. Radionuclide angiography reveals this cardiac injury is dynamic and more frequent than previously thought.

Area of Science:

Cardiology
Trauma Medicine
Diagnostic Imaging

Background:

Traumatic myocardial dysfunction is an underdiagnosed cause of trauma-related mortality.
Electrocardiography and serum enzymes are unreliable for detecting cardiac injury post-blunt chest trauma.

Purpose of the Study:

To evaluate the diagnostic accuracy of first-pass biventricular radionuclide angiography in assessing traumatic myocardial dysfunction.
To compare radionuclide angiography findings with electrocardiograms and creatine kinase isoenzyme levels in trauma patients.

Main Methods:

Seventy-four patients with blunt chest and multisystem trauma were assessed.
Electrocardiograms and creatine kinase-MB levels were monitored for 3 days.
First-pass radionuclide angiography was performed 24-48 hours post-admission to assess ventricular function and wall motion.

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Main Results:

Radionuclide angiography detected abnormalities in 74% of patients, significantly higher than electrocardiogram (28%) or creatine kinase (8%) abnormalities.
Electrocardiographic findings correlated with angiographic abnormalities in 76% of cases.
Follow-up angiography showed resolution of abnormalities in 75% of patients within 3 weeks, indicating a dynamic process.

Conclusions:

Electrocardiograms and creatine kinase isoenzyme are insensitive, static indicators of traumatic myocardial dysfunction.
First-pass radionuclide angiography is a practical and valuable tool for detecting and managing traumatic myocardial dysfunction, revealing its common and dynamic nature.