Diagnosing myocardial contusion after blunt chest trauma

A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms [ECGs] and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored

perioperative effect of ascorbic acid on inflammatory response in coronary artery bypass graft surgery; a randomized controlled trial coronary artery bypass graft surgery

Different pharmacological agents may decrease the inflammatory response during cardiac surgery. The aim of this study was to evaluate the effect of ascorbic acid as an antioxidant on inflammatory markers [interleukins 6 and interleukin 8] released during cardiopulmonary bypass. Forty patients scheduled for elective coronary artery bypass grafting surgery, were randomly assigned to two groups. The patients in the case group were given 3 grams ascorbic acid 12-18 hours before operation and 3 grams during CPB initiation. The patients in the control group were given the same amounts of normal saline at similar times. Blood samples were collected 6 hours preoperatively and postoperative serum interleukin 6 and 8 were measured using enzyme-linked immunosorbent assay [ELISA]. In both groups CPB caused an increase in IL6 and IL8 plasma concentrations ; compared with baseline levels, but the pattern of changes at such levels were similar in both groups after receiving ascorbic acid or placebo. Ascorbic acid did not reduce the inflammatory cytokines during CPB. Compared to the placebo, ascorbic acid had no significant effect on hemodynamic parameters such as systolic and diastolic blood pressure, heart rate, arterial blood gases, BUN, Creatinine and WBC and platelet counts. Ascorbic acid has no effect on the reduction of IL6 and IL8 during CPB. Also, it causes no improvement in hemodynamics, blood gas variables, and the outcomes of patients undergoing CABG