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May 10, 1965


JAMA. 1965;192(6):568-569. doi:10.1001/jama.1965.03080190134031

Contusion of the myocardium is not rare. Any severe injury of the anterior thorax may cause it, the usual causes being deceleration injuries from high-speed highway accidents, blast (dynamite and gas heating units), and farm accidents involving tractors or animals.

The clinical features are frequently similar to those of myocardial infarction: the chest pain may be identical, tachycardia is almost always present, and the electrocardiogram is often abnormal. The serum glutamic oxaloacetic transaminase level is not usually helpful in diagnosing contusion because the enzyme is found in high concentration in bone, muscle, and other tissue frequently damaged by the bruising force. As with early infarction, the ECG may not show change immediately after injury. Therefore, in severe chest injuries an ECG should be made on admission, and if normal, should be repeated in a day or two.1

The search for possible myocardial contusion is especially necessary if the administration