Cardiac strain and trauma

1. (1) The importance of an accurate and careful appraisal of cause-effect relationship in cardiac trauma, both direct and indirect, has been emphasized. 2. (2) The physiologic and clinical description of the pathogenesis of cardiac damage, secondary to trauma and strain, has been reviewed. 3. (3) Evidence indicates that trauma and strain may be considered significant if associated in a temporal sequence with clinical and/ or laboratory evidence of cardiac damage. 4. (4) Varied criteria of diagnosis of early or minimal cardiac changes have been reviewed, including electrocardiographic patterns, changes in serum enzymes, and clinical abnormalities. 5. (5) Illustrative case histories are included to demonstrate the application of these criteria in an evaluation of effort or strain in relation to cardiac damage.