CPK-MB isoenzume determinations in blunt chest trauma.

To identify the most sensitive screening test for cardiac contusions, a series of 35 patients with blunt chest trauma was evaluated with serial electrocardiograms (ECGs)- creatine phosphokinase isoenzymes, and serum enzymes (serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, and creatine phosphokinase). Twenty of the 35 patients had diagnoses of cardiac contusions by ECG. Three with contusions developed complications. Although isoenzyme elevation was present in most patients sustaining blunt chest trauma, no complications of the injury were seen in patients with elevated enzymes and normal ECGs. The ease of obtaining ECGs and their reliability in identifying patients who will have complications make it the best screening procedure for the diagnosis of cardiac contusions.