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Myocardial Contusion

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

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Basics

Description

  • 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

Etiology

  • 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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Citation

Rosen, Peter, et al., editors. "Myocardial Contusion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307571/all/Myocardial_Contusion.
Myocardial Contusion. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307571/all/Myocardial_Contusion. Accessed April 26, 2019.
Myocardial Contusion. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307571/all/Myocardial_Contusion
Myocardial Contusion [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307571/all/Myocardial_Contusion.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Myocardial Contusion ID - 307571 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307571/all/Myocardial_Contusion PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -