Myocardial contusion. When can the diagnosis be eliminated?

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 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.