Cardiac injury after chest trauma
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Updated: Oct 7, 2026
A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion
Published on: July 17, 2012
Insights
Severe chest trauma often causes minor cardiac injury, but rarely myocardial contusion. Elevated cardiac enzymes are common, but myocardial isoenzymes help distinguish contusion. Traumatic pericarditis can occur without ECG changes.
Area of Science:
- Emergency Medicine
- Cardiology
- Trauma Surgery
Background:
- Severe chest trauma frequently leads to cardiac injury.
- Diagnostic evaluation of cardiac injury in trauma is crucial.
- Understanding the utility of diagnostic studies is important.
Purpose of the Study:
- To evaluate the frequency of significant cardiac injury in severe chest trauma.
- To determine the usefulness of diagnostic studies for cardiac injury.
- To differentiate myocardial contusion from other cardiac injuries.
Main Methods:
- Prospective study of 50 consecutive patients with severe chest trauma.
- Assessment of cardiac enzymes and electrocardiograms (ECGs) on admission.
- Monitoring for persistent ECG changes and complications.
Main Results:
- 49/50 patients had elevated cardiac enzymes; 26/50 had abnormal ECGs.
- Persistent ECG changes (>48h) occurred in only 3 patients.
- 5 patients developed significant pericarditis, 2 without ECG abnormalities.
Conclusions:
- Minor cardiac injury is common in severe chest trauma.
- Myocardial isoenzymes are useful in diagnosing myocardial contusion.
- Traumatic pericarditis can occur without ECG changes and requires consideration in unstable patients.
Abstract:
Fifty consecutive patients with severe chest trauma were studied prospectively to evaluate the frequency of significant cardiac injury and to determine what diagnostic studies were useful. Forty-nine of 50 patients had elevated cardiac enzymes and 26 of 50 had abnormal ECGs on admission. No patient had complications associated with myocardial infarction, including 15 who underwent general anesthesia. We found persistent (greater than 48 h) ECG changes in only 3, 2 of these 3 also had markedly elevated MB fraction of CPK. Significant pericarditis occurred in 5 patients, 2 of whom never had ECG abnormalities. We conclude that minor cardiac injury is common in severe chest trauma, but only rarely causes myocardial contusion. Myocardial isoenzymes may be useful in making that important distinction. Clinically significant traumatic pericarditis may occur in the absence of ECG changes and must be considered in every patient with chest injury and unstable hemodynamics.
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