CV

Cardiac Contusion

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Cardiac Contusion, Blunt Cardiac Injury, Blunt Myocardial Injury, Myocardial Contusion, Heart Contusion

  • Causes
  1. Chest Traumatic Injury
  2. High speed injury (e.g. MVA)
  • History
  1. Bent stearing wheel in a Motor Vehicle Accident
  • Symptoms
  • Signs
  1. Hypotension
  2. Anterior chest wall injury
  3. Sternal Fracture signs
    1. Sternal tenderness
    2. Sternal deformity
  • Labs
  1. Serial Troponin levels
  2. Serum myoglobin
  3. Serum CK-MB
  • 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
  • Imaging
  • Differential Diagnosis
  1. See Blunt Chest Trauma
  2. See associated conditions below
  3. Rib Fracture
  • Management
  1. ABC Management
  2. Manage Hypoxia, Hypotension and identified complications
  3. Indications for observation (24 hour)
    1. Electrocardiogram abnormalities
  • References
  1. (2012) ATLS, ACOS, p. 105
  2. Killu and Sarani (2016) FCCS, p. 160-1