BACKGROUND: Controversy surrounds diagnostic tests and their ability to predict the early cardiovascular complications in blunt cardiac trauma patients. AIMS: We evaluated electrocardiogram (ECG), cardiac troponin-I (Tn-I) and creatine kinase-MB (CK-MB) levels to diagnose myocardial contusion (MC) in chest trauma patients. SETTINGS AND DESIGN: A total of 50 chest trauma cases were randomly included in the study. Patients with a history of ischemic heart disease or myocardial infarction and/or treatment with anti-anginal or antihypertensive drugs were excluded. MATERIAL AND METHODS: ECG, CK-MB, creatinine phosphokinase (CPK), and Tn-I were recorded at admission and repeated at 24 and 72 hours. Patients were grouped as suspected or nonsuspected MC group based on any of the following: Abnormal ECG; CK-MB >50 U/L; CK-MB/CPK ratio>5; Tn-I >1.5ng/ml. Suspected MC group patients were sub-grouped as significant MC group: If they had-abnormal echocardiographic findings such as regional wall motion abnormalities, regurgitant lesions; unexplained hemodynamic instability and shock with systolic blood pressure <90mmHg; patients unresponsive to fluid resuscitation in spite of replacement of estimated blood loss; or patients requiring vasopressor for cardiogenic shock. STATISTICAL ANALYSIS: Student's ttest, Z-test and sensitivity analysis were performed for statistical analysis. RESULTS: Of 50 patients, 44 belonged to suspected MC group; 15 of them had significant MC. ECG was the most sensitive (93.3%) indicator of MC whereas Tn-I showed high specificity (86.20%) for MC. CONCLUSIONS: Troponin-I is a specific marker of MC while ECG is a sensitive diagnostic tool.
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