II. Causes

  1. Chest Traumatic Injury
  2. High speed injury (e.g. MVA)

III. History

  1. Bent stearing wheel in a Motor Vehicle Accident

IV. Symptoms

V. Signs

  1. Hypotension
  2. Anterior chest wall injury
  3. Sternal Fracture signs
    1. Sternal tenderness
    2. Sternal deformity

VI. Labs

  1. Serial Troponin levels
  2. Serum myoglobin
  3. Serum CK-MB

VII. Diagnostics

  1. Telemetry monitoring
  2. Electrocardiogram (EKG) - obtain serial EKGs
    1. See EKG monitoring in Trauma
    2. Premature Ventricular Contractions (PVC)
    3. Unexplained Sinus Tachycardia
    4. Atrial Fibrillation
    5. Right Bundle Branch Block
    6. ST Segment changes
      1. Myocardial Infarction may occur in blunt cardiac Trauma
  3. Advanced hemodynamic monitoring (if central access)
    1. Central Venous Pressure increased

VIII. Imaging

IX. Differential Diagnosis

  1. See Blunt Chest Trauma
  2. See associated conditions below
  3. Rib Fracture

XI. Management

  1. ABC Management
  2. Manage Hypoxia, Hypotension and identified complications
  3. Indications for observation (24 hour)
    1. Electrocardiogram abnormalities

XII. References

  1. (2012) ATLS, ACOS, p. 105
  2. Killu and Sarani (2016) FCCS, p. 160-1

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Related Studies

Ontology: Contusion to heart (C0273112)

Definition (NCI_FDA) A bruise to the heart.
Definition (NCI) A bruise to the heart.
Concepts Injury or Poisoning (T037)
ICD10 S26.81
SnomedCT 210054006, 17414004
English Myocardial Contusion, myocardial contusion (diagnosis), myocardial contusion, cardiac contusions, cardiac contusion, contusion heart, contusions heart, heart contusion, CONTUSION, MYOCARDIAL, MYOCARDIAL CONTUSION, CARDIAC CONTUSION, CONTUSION, CARDIAC, Cardiac contusion, Contusion to heart, Myocardial contusion, Contusion of heart, Contusion to heart (disorder)
Czech Konture srdce, Kontuze myokardu
Dutch myocardcontusie, hartkneuzing
French Contusion myocardique, Contusion cardiaque
German Herzkontusion, Myokardprellung
Hungarian Szív-contusio, Myocardialis contusio
Italian Contusione miocardica, Contusione cardiaca
Japanese シンゾウザショウ, シンキンザショウ, 心筋挫傷, 心臓挫傷
Portuguese Contusão cardíaca, Contusão miocárdica
Spanish Contusión cardiaca, Contusión miocárdica, contusión cardíaca, contusión miocárdica (trastorno), contusión miocárdica