Objective Evaluation of Blunt Cardiac Trauma

Serum creatine kinase isoenzyme (CK-MB) screening followed by two-dimensional echocardiography (2-DE) was used for the assessment of possible cardiac injury in victims of blunt trauma with acute thoracic or rapid deceleration injury. Of 291 victims evaluated acutely, 58 (20%) had a CK-MB fraction evident within 24 hours after injury. Sixty per cent (35/58) were diagnosed as having ʼcardiac concussionʼ (normal 2-DE) and 40% (23/58) as having ʼcardiac contusionʼ (abnormal 2-DE). 2-DE abnormalities most often involved the right ventricle and were characterized by dyskinesis. Only one of 35 concussion patients (3%) and nine of 23 contusion patients (39%) manifested cardiac arrhythmias within 72 hours after injury (p