J Trauma
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The diagnosis of blunt cardiac injury in traumatized patients is problematic and the implications of such a diagnosis are not clear. Although cardiac selective creatine kinase (CK-MB) assays and electrocardiograms (EKG) are the most widely available laboratory investigations, they often correlate poorly with diagnoses made on clinical grounds, or by other laboratory methods. We therefore retrospectively studied the Montreal General Hospital experience with 342 consecutive blunt trauma patients admitted to our surgical intensive care/trauma unit. ⋯ We conclude that although blunt cardiac injury is an important source of morbidity and mortality its 'diagnosis' is not the issue. Rather, it is more important to recognize which of these clinically identified 'high-risk' patients will actually develop cardiac complications. We feel our approach will enable clinicians to do this.