This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (39)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

When Can the Diagnosis Be Eliminated?

Frank B. Miller, MD; Charles R. Shumate, MD; J. David Richardson, MD

Arch Surg. 1989;124(7):805-808.

Abstract
• The clinical significance of various diagnostic tests and the length of monitoring required for myocardial contusion were evaluated in 172 patients. Cardiac isoenzyme levels, electrocardiograms, and echocardiograms were evaluated. Twenty-eight patients had a documented myocardial contusion based on at least one positive diagnostic study. The majority of positive studies were detected on admission and all positive tests were present within 24 hours. No patients developed positive diagnostic studies after 24 hours and, likewise, no clinical deterioration occurred late or in patients with a negative screening examination. The electrocardiogram and the clinical course were the primary determinants of the need for cardiac monitoring and therapeutic intervention. Cardiac isoenzyme levels had negligible significance on outcome, and the two-dimensional echocardiogram was not particularly valuable as a screening technique. If no abnormality is detected within 24 hours post injury, further investigation or monitoring does not appear warranted.

(Arch Surg. 1989;124:805-808)

Author Affiliations
From the Department of Surgery, University of Louisville (Ky) School of Medicine.

Footnotes
Accepted for publication April 5, 1989.

Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 15, 1988.

Reprint requests to Department of Surgery, University of Louisville, Louisville, KY 40292 (Dr Miller).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Bifascicular Block Complicating Blunt Cardiac Injury: A Case Report and Review of the Literature
Pontillo et al.
ANGIOLOGY 1994;45:883-890.
ABSTRACT  

Diagnosis of Myocardial Contusion: Quantitative Analysis of Single Photon Emission Computed Tomographic Scans
Godbe et al.
Arch Surg 1992;127:888-892.
ABSTRACT