Cardiac damage after blunt chest trauma, diagnosed using CK-MB enzyme and electrocardiogram.

In the present study, 78 patients with a blunt thorax trauma were examined. Fifty-four percent of the patients had been injured in traffic. Creatinine kinase (CK) and its isoenzymes (MM, MB and BB), ASAT, ALAT, ECG and thorax X-ray were taken. In 24% of the patients examined, the activity of serum MB isoenzyme was greater than or equal to 6% of the total activity of CK, and in 40% no MB activity was observed. Pathological ECG changes were detected in 89% in the MB greater than or equal to 6% group and in 32% in the MB = 0% group. ECG changes cannot be regarded as specific indicators of cardiac contusion. Arrhythmias, conduction defects, ST segment and T wave changes, and a pathologically long QTc interval were present significantly more often (P less than 0.01) in the MB greater than or equal to 6% group than in the MB = 0% group. Roentgenologically, pulmonary contusion, cardiac dilatation and venous congestion-pulmonary edema were diagnosed more frequently in the MB greater than or equal to 6% group (P less than 0.01) than in the MB = 0% group. Eleven of the patients died. A forensic autopsy was performed on these patients, and a macroscopic heart injury was detected in five of them. Serum MB activity had been found in all these five.