Early diagnosis of myocardial contusion in patients with blunt chest trauma: a review

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Abstract

Blunt chest trauma is among the most clinically significant problems in traumatology and cardiology. The most severe and life-threatening injuries in blunt chest trauma include cardiac damage, particularly myocardial contusion. In peacetime, myocardial contusion occurs as a result of mechanical impact on the chest. Most commonly, this situation develops during high-speed motor-vehicle collisions at the moment of abrupt deceleration, when the chest strikes the steering wheel or steering column. Timely diagnosis and treatment of myocardial contusion are essential for reducing complications associated with blunt chest trauma. The this review aimed to examine and evaluate the diagnostic approaches available for patients with blunt chest trauma by analyzing data from Russian and international studies. A scientific data search was conducted in medical publication databases including PubMed, CyberLeninka, Google Scholar, Scopus, Medline, and the Cochrane databases, covering articles in English, Chinese, Italian, and Russian, as well as via the Web of Knowledge platform. Based on the reviewed Russian and international studies, we found that none of the currently available ante-mortem diagnostic methods provides a high probability of detecting myocardial contusion in the early post-traumatic period. The clinical presentation of myocardial contusion is likewise nonspecific, which prevents identification of this type of injury in most cases. This leads to the absence of timely and adequate therapy and contributes to the development of various complications, including fatal outcomes. At present, histological examination of myocardial tissue remains the only definitive diagnostic method for myocardial contusion; however, it cannot be performed during life. Identifying new methods for the timely diagnosis of myocardial contusion is an urgent interdisciplinary challenge. This article provides a rationale for assessing markers of secondary mitochondrial dysfunction in cardiomyocytes as a potential approach for the early diagnosis of blunt myocardial contusion.

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About the authors

Elena A. Stark

Russian University of Medicine

Author for correspondence.
Email: starkelena@mail.ru
ORCID iD: 0009-0006-7093-1494
SPIN-code: 1294-6047
Russian Federation, Moscow

Mikhail V. Parshikov

Russian University of Medicine

Email: parshikovmikhail@gmail.com
ORCID iD: 0000-0003-4201-4577
SPIN-code: 5838-4366

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Nikolay V. Yarygin

Russian University of Medicine

Email: dom1971@yandex.ru
ORCID iD: 0000-0003-4322-6985
SPIN-code: 3258-4436

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Moscow

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2. Fig. 1. Screening algorithm for identifying patients at risk of cardiac complications depending on the severity of concomitant injuries. ECG, electrocardiogram.

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