Myocardial Concussion


Background
  1. Very specific form of blunt cardiac trauma

Pathophysiology

  1. Sharp blow to chest "stuns" myocardium
  2. Blow causes dysrhythmia
  3. Often results in immediate cardiac arrest
  4. No histopathological changes are found at autopsy
  5. Proposed injury mechanisms

Diagnostics

  1. Diagnosis is by history of event
  2. No specific physical findings or other tests
  3. ECGs show V-fib or asystole
  4. ECGs of survivors may show:

Treatment

  1. Immediate defibrillation at scene is critical
  2. Begin CPR
  3. Treat per ACLS protocols

Disposition

  1. Admission to ICU for status-post cardiac arrest
  2. Thorough cardiac evaluation