Serum glutamic-oxalacetic transaminase activity in conditions associated with myocardial infarction. I. Bodily trauma

Postoperative course of serum aminotransferases after total hip arthroplasty

Skeletal muscle trauma and acute coronary occlusion increase the values of aminotransferases, which might render the diagnosis of myocardial infarction in connection with major orthopaedic surgery more difficult. To find clinically useful distinctions, the postoperative course of serum aminotransferases (ASAT, ALAT, LD, GT and ALP) was recorded for the first 3 weeks following total hip arthroplasty and compared with the values found in patients with acute myocardial infarction. The level of ASAT increased during the first days following surgery. The highest recorded value of ASAT during the first 4 days was found to be lower than corresponding values in patients with myocardial infarction, although an overlap between the groups was seen. However, the LD value did not increase significantly following surgery, in contrast to the findings in patients with myocardial infarction. Later in the postoperative course, values for ALAT, GT and ALP rose as well. Two case reports on myocardial infarction after total hip replacement are included.

Myocardial contusion in blunt chest trauma: a ten-year review

A retrospective review was undertaken of 169 patients admitted to an Intensive Therapy Unit with a major chest injury to determine the incidence, clinical features and outcome of patients with myocardial contusion. This injury occurred in 29 (17%) patients, of whom 24 (83%) had significant cardiovascular complications and five died as a direct result of the injury. The interval between injury and diagnosis was 3.2 +/- 2.3 days (mean +/- SD) from injury and in six patients the diagnosis was made only at necropsy. Increased awareness of myocardial contusion is required for earlier diagnosis and prevention of complications.

The electrocardiographic and clinical diagnosis of myocardial contusion

The clinical features and treatment of 34 patients with myocardial contusion is presented. The value of specific clinical features for diagnosis is discussed. Guidlines for therapy are presented.

Serum Glutamic Oxaloacetic and Pyruvic Transaminases in a Case of Cardiac Arrest Resuscitated by External Cardiac Massage

Serial serum transaminase determinations were made before and following cardiac arrest encountered during retrograde left ventricular catheterization and successfully managed by external cardiac massage. Prompt, significant elevation of serum glutamic oxaloacetic transaminase and slight rise in serum pyruvic transaminase occurred without evidence of myocardial infarction. Skeletal muscle trauma appeared the most likely cause.