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Blunt Cardiac Injury

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Normal electrocardiography and serum troponin I levels preclude the presence of clinically significant blunt cardiac injury.
Velmahos GC, Karaiskakis M, Salim A, Toutouzas KG, Murray J, Asensio J, Demetriades D.
J Trauma. 2003 Jan;54(1):45-50; discussion 50-1.

Rationale for inclusion: Normal admission and 8 hour EKG and troponin I rules out blunt cardiac injury.

Citations - 144 (as of July 2017)

Clinically significant blunt cardiac trauma: role of serum troponin levels combined with electrocardiographic findings.
Salim A, Velmahos GC, Jindal A, Chan L, Vassiliu P, Belzberg H, Asensio J, Demetriades D.
J Trauma. 2001 Feb;50(2):237-43.

Rationale for inclusion: The negative predictive value of a normal EKG and troponin I was 100%.  18 of 19 patients who developed symptoms did so within 24hrs.

Citations - 138 (as of July 2017)

Evaluation of incidence, clinical significance, and prognostic value of circulating cardiac troponin I and T elevation in hemodynamically stable patients with suspected myocardial contusion after blunt chest trauma.
Bertinchant JP, Polge A, Mohty D, Nguyen-Ngoc-Lam R, Estorc J, Cohendy R, Joubert P, Poupard P, Fabbro-Peray P, Monpeyroux F, Poirey S, Ledermann B, Raczka F, Brunet J, Nigond J, de la Coussaye JE.
J Trauma. 2000 May;48(5):924-31.

Rationale for inclusion: Troponin I and T had low sensitivity but good specificity in predicting myocardial contusion.

Citations - 193 (as of July 2017)

The role of echocardiography in blunt chest trauma: a transthoracic and transesophageal echocardiographic study.
Karalis DG, Victor MF, Davis GA, McAllister MP, Covalesky VA, Ross JJ Jr, Foley RV, Kerstein MD, Chandrasekaran K.
J Trauma. 1994 Jan;36(1):53-8.

Rationale for inclusion: Prospective evaluation of TTE and TEE I 105 patients.  TEE was found to be of benefit when TTE was nondiagnostic.

Citations - 206 (as of July 2017)

Nonpenetrating traumatic injury of the heart.
Parmley LF, Manion WC, Mattingly TW,
Circulation. 1958 Sep;18(3):371-96.

Rationale for inclusion: Describes the lesions found at 546 autopsy cases with blunt cardiac injuries, finding that death most often occurs as a result of ventricular rupture.

Citations - 587 (as of July 2017)

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