Myocardial Contusion


Background
  1. Cardiac injuries due to blunt force trauma
  2. Involves a spectrum of injuries
  3. Injury mechanism

Pathophysiology

  1. Injury basics
  2. Multiple tissue-level insults
  3. Mechanics of injury
  4. Site of involvement:
  5. Injury sequelae:

Diagnosis

  1. History
  2. Physical exam (no specific clinical signs)
  3. Diagnostic testing
  4. Diagnostic imaging

Differential Diagnosis

  1. Cardiac tamponade
  2. Tension/ open pneumothorax
  3. Hemothorax
  4. Pulmonary contusion
  5. Flail chest/ rib fractures
  6. Ruptured diaphragm
  7. Ruptured esophagus
  8. Tracheobronchial tree rupture

Treatment

  1. ATLS
  2. IV, O2 & cardiac monitor
  3. Dysrhythmias
  4. Hypotensive patients

Disposition

  1. Most patients are trauma patients and are admitted
  2. If only contusion is being evaluated for