Abstract
Aims: The objective of this study was to assess the incidence of myocardial contusion after
traumatic sternal fracture. Methods: 202 patients with traumatic sternal fractures after blunt chest trauma who were treated
at the Department of Traumatology, Medical University of Vienna, Austria, from January
1992 to August 2005 were retrospectively evaluated for signs of cardiac complications.
Results: Among all patients only 16 ECG abnormalities were registered within the first 24
hours of hospitalisation. The abnormalities consisted of irregular sinus bradycardia,
extrasystole, right bundle branch block, A-V block (I°), signs of right heart exertion,
and T-wave changes. Total serum creatine phosphokinase (CK) values and isoenzyme determinations
of the MB fraction as well as LDH were initially measured in 188 patients. 45 patients
had an increased level of CK-MB initially following trauma. Common ECG abnormalities
and enzyme level elevations were observed in only 7 of our patients. Conclusion: Although cardiac complications could not be observed in any of our patients, the
presence of myocardiac contusion should be ruled out by performing ECG and evaluation
of cardiac enzyme levels after fractures of the sternum. We believe that patients
with sternal fractures who show an ECG or enzyme abnormality should be admitted and
monitored for at least twenty-four hours after the accident.
Key words
Sternal fractures - myocardiac contusion - ECG abnormality - creatine phosphokinase
- isoenzyme determinations
References
