Diagnosis of myocardial contusion in blunt chest trauma

Of 20 patients with blunt chest trauma who underwent cardiac scanning, serial electrocardiography and cardiac monitoring to rule out myocardial contusion, four had positive cardiac scans. All four had electrocardiographic abnormalities: three had nonspecific ST-T wave changes, and the fourth had electrocardiographic evidence of an acute subendocardial infarction. Of the 16 patients with negative scans, five had normal electrocardiograms. In the remaining 11 patients, factors other than myocardial contusion were suspected causes of electrocardiographic abnormalities. On the basis of this data, electrocardiogram changes in the traumatized patient have various causes. Cardiac scanning appears to be a useful adjunct to electrocardiography in confirming the presence of myocardial contusion.