American heart journal
-
American heart journal · Feb 1996
Comparative StudyLast-minute preoperative cardiology consultations: epidemiology and impact.
To identify clinical predictors of last-minute preoperative cardiology consultations and to evaluate the impact of these consultations on patient care, we performed a retrospective case-control study including all 166 patients who received unscheduled cardiology consultations at the preadmission testing center (PATC) of an urban teaching hospital. Control subjects were 166 patients matched by date and category of surgical procedure. ⋯ Thus among patients undergoing elective noncardiac surgery, last-minute preoperative consultations are common and are usually precipitated by an abnormal electrocardiogram or history of cardiovascular disease. Last-minute consultations may be preventable if those patients with risk factors for consultation are identified in advance of the preadmission evaluation and referred for elective consultation.
-
American heart journal · Feb 1996
Comparative StudyImproved detection of cardiac contusion with cardiac troponin I.
Detecting cardiac injury in patients with chest trauma is difficult because the level of the MB isoenzyme of creatine kinase (MBCK) can be elevated from skeletal muscle injury alone. However, the level of cardiac troponin I (cTnl) is not elevated by skeletal muscle injury. To determine whether its measurement would improve the ability to detect cardiac injury in patients with blunt chest trauma, 44 patients were studied. ⋯ Twenty-six of the 37 patients without contusion had elevations of MBCK; none had elevations of cTnl. The ratio of MBCK to total creatine kinase improved specificity at the expense of sensitivity. Measurement of cTnl accurately detects cardiac injury in patients with blunt chest trauma and should facilitate the diagnosis and management of such patients.