Myocardial Contusion

Myocardial Contusion is a topic covered in the 5-Minute Emergency Consult.

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  • Also known as blunt cardiac injury
  • Pathologically characterized by discrete and well-demarcated area of hemorrhage
  • Usually subendocardial
  • May extend in pyramidal transmural fashion
  • Most commonly involves anterior wall of right ventricle or atrium due to anatomic location


  • Blunt trauma to chest:
    • High-speed deceleration accidents
    • May occur in accidents with speeds as low as 20–35 mph
  • Auto–pedestrian injuries
  • Falls
  • Prolonged closed-chest cardiac massage
  • Heart may be compressed between sternum and vertebrae.
  • Heart strikes sternum during deceleration.
  • Heart is damaged by abdominal viscera upwardly displaced by force on abdomen.
  • Concussive forces (e.g., explosion)
  • Associated conditions:
    • Life-threatening dysrhythmias
    • Cardiogenic shock/CHF
    • Hemopericardium with tamponade
    • Valvular/myocardial rupture
    • Intraventricular thrombi
    • Thromboembolic phenomena
    • Coronary artery occlusion from intimal tearing or adjacent hemorrhage and edema may rarely occur.

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