A plea for sensible management of myocardial contusion

B. Timothy Baxter, Ernest E. Moore, Frederick A. Moore, Brian L. McCroskey, Lee Anne Ammons

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


The purpose of this study was to define the relative risk of life-threatening sequelae in patients at risk for myocardial contusion. During a 3-year period, 280 patients sustaining blunt chest trauma were admitted to the surgical intensive care unit to exclude myocardial contusion. Patients were evaluated by electrocardiogram and creatine phosphokinase (CPK) MB enzyme levels every 8 hours for a minimum of 48 hours. Myocardial contusion was identified in 35 patients (13 percent); the diagnosis was established by transient electrocardiographic changes (30), CPK-MB more than 3 percent (9) or both criteria (4). Two patients (1 percent) died from cardiac decompensation 4 and 12 hours postinjury, and seven (3 percent) required early (12 hours postinjury) intensive care unit treatment of arrhythmias or myocardial failure. None of the remaining 271 patients developed cardiac symptoms. This clinical experience underscores the low incidence of cardiac sequelae among patients at risk for myocardial contusion. Complications were always manifest within 12 hours of injury. The clinical diagnosis of myocardial contusion can be excluded pragmatically in the asymptomatic patient with a normal electrocardiogram and CPK-MB levels during the initial 24-hour postinjury period.

Original languageEnglish (US)
Pages (from-to)557-562
Number of pages6
JournalThe American Journal of Surgery
Issue number6
StatePublished - Dec 1989
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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