Myocardial contusion Definition
Myocardial contusion is a bruise of the heart
Blunt myocardial injury
The most common causes are:
A severe myocardial contusion may lead to signs and symptoms of a heart attack.
Symptoms can include:
Pain in the front of the ribs or breastbone
Feeling that your heart is racing
Nausea or vomiting
Shortness of breath
Exams and Tests
The doctor or nurse will perform a physical exam. This may show:
Bruise or scrapes on the chest wall
Crunching sensation when touching the skin if there are rib fractures and puncture of the lung
Low blood pressure
Rapid or shallow breathing
Tenderness to the touch
Abnormal chest wall movement from rib fractures
Tests may include:
These tests may show:
Problems with the heart wall and the ability for the heart to contract
Fluid or blood in the thin sac surrounding the heart (pericardium)
Rib fractures, lung or blood vessel injury
Problem with the heart's electrical signaling (such as a bundle branch block or other heart block)
Fast heart beat starting at the sinus node of the heart (sinus tachycardia)
Abnormal heart beat starting in the ventricles or lower chambers of the heart (ventricular dysrhythmia) Treatment
In most cases, you will be closely monitored for at least 24 hours. An electrocardiogram (ECG) will be done continually to check your heart function.
Emergency room treatment may include:
Catheter placement through a vein (IV)
Medications to relieve pain, heart rate disturbances, or low blood pressure
Pacemaker (temporary, may be permanent later)
Other therapies may be used to treat a heart injury, include:
Chest tube placement
Draining blood from around the heart
Surgery to repair blood vessels in the chest Outlook (Prognosis)
People with a mild myocardial contusion will recover completely most of the time.
Serious heart injuries can increase your risk for heart failure or heart rhythm problems.
The following safety tips may help prevent a heart bruise:
Wear a seat belt when driving.
Choose a car with air bags.
Take steps to ensure safety when working at heights. References
Eckstein M, Henderson SO. Thoracic trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds.
Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby Elsevier; 2013:chap 45.
Jones RF, Rivers EP. In: Roberts JR, Hedges JR, eds.
Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 18.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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