The pathophysiology, clinical presentation, and a critical evaluation of the diagnostic tests used in the confirmation of this entity are reviewed, and an approach to the evaluation and management of these patients is presented. [ncbi.nlm.nih.gov]

She only presented mild pain on palpation in the lower sternal region, with no associated signs or symptoms. Three hours after hospitalization, ECG and myocardial enzymes presented no alterations (troponin I: 0.20 ng/ml). [elsevier.es]

• Chest Pain

  A young man was in a rollover Motor Vehicle Collision, with a chest laceration and chest pain. [hqmeded-ecg.blogspot.com]

  Medicines may be prescribed to relieve chest pain, heart rate abnormalities, or low blood pressure that can arise from Myocardial Contusions. [dovemed.com]

  A fractured sternum indicates high kinetic energy at the impact and elevated Troponin levels and chest pain after such an injury confirm myocardial contusion. [radiopaedia.org]

  Although he is conscious and responsive, he reports severe chest pain. His blood pressure is 83/55 mmHg, pulse is 120/min, and respirations are 24/min. On physical exam, he has extensive ecchymosis over his anterior chest wall. [medbullets.com]

  Clinical picture is varied and nonspecific: Chest pain Cardiogenic shock Subtle EKG changes without clinical symptoms Most common sign is tachycardia out of proportion to degre... [5minuteconsult.com]

• Heart Disease

  Of these patients, 6 had biventricular dysfunction, 1 had isolated abnormal left ventricular function, and 2 had isolated abnormal right ventricular function in the absence of chronic obstructive pulmonary disease or preexisting heart disease. [ncbi.nlm.nih.gov]

  Traumatic heart disease, in: zipes DP, Libby P, Bonow RO, Braunwald E, editors: braunwald's heart disease: a textbook of cardiovascular medicine. 7 th ed Philadelphia: Elsevier Saunders. 2005; 7: 1781-8. Google Scholar Guo H, Chi J, Yuan M, Qiu Y. [panafrican-med-journal.com]

  Traumatic heart disease. In: Levine GN, ed. Cardiology Secrets. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 71. Raja AS. Thoracic trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. [medlineplus.gov]

  Commotio cordis is sudden cardiac arrest that follows a blow to the anterior chest wall in patients who do not have pre-existing or traumatic structural heart disease. [msdmanuals.com]

  Attribution Author: Eric Berlin, MD Date Written: Editor: Ballenberg, Sally, BS Edit Date: 08/31/01 Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 07/31/01 Sources Merck Manual 1999 Harrison's Principles of Internal Medicine 1991 Heart Disease: A [medicineonline.com]

• Jugular Venous Distention

  He has jugular venous distention and muffled heart sounds. An electrocardiogram reveals diffused ST elevations and sinus tachycardia. A focused assessment with sonography in trauma (FAST) exam reveals pericardial fluid. [medbullets.com]

  venous distention (right ventricular failure, tamponade) Signs of left ventricular failure: tachypnea, rales, pleural effusion, S3 (aneurysm, infarction, valvular disruption, VSD) Signs of right ventricular failure: jugular venous distention, hepatomegaly [tele.med.ru]

• Suggestibility

  Criteria for observation following isolated, minor blunt chest trauma are suggested. Hospital and trauma registry records of patients admitted over a 33-month period with suspected MCC were reviewed. [ncbi.nlm.nih.gov]

• Impulsivity

  Cardiac contusion may be frequently found in patients with blunt chest trauma, and it presents clinically as a spectrum of injuries of varying severity, including transient disorders of impulse formation and propagation. [ncbi.nlm.nih.gov]

  […] myocardial contusion may have the following effects: bleeding into the membrane that surrounds the heart, which can cause cardiac tamponade bleeding within the heart muscle conduction problems, or an abnormality in the transmission of the electrical impulses [medicineonline.com]

Of the 644 admissions to monitored beds, 95 had workups for suspected contusion. Heart failure not obvious on admission did not occur and there were only four arrhythmias that required treatment. [ncbi.nlm.nih.gov]

The authors concluded that a cTnI greater than 1.05 µg/L necessitated further workup. Neither CK total or CK-MB were helpful in predicting BCI. [east.org]

Radiologic workup revealed a bilateral pleural effusion, a fracture of the right collarbone, a hepatic contusion, a right adrenal hematoma and a fracture of the left iliac wing. [panafrican-med-journal.com]

The initial workup revealed elevated cardiac troponin T of 0.576 μg/L (normal range, 0.00 to 0.03 μg/L) and creatine kinase-MB levels of 25.4 U/L (normal range, 0 to 25 U/L); the markers of inflammation proved to be negative (C-reactive protein level, [circ.ahajournals.org]

• Mural Thrombus

  Echocardiography showed global right ventricular dysfunction but a right ventricular mural thrombus, the likely source of the pulmonary emboli, was not seen. He gradually recovered after treatment with anticoagulant. [ncbi.nlm.nih.gov]

• ST Elevation

  ST elevation in inferior and lateral leads. [hqmeded-ecg.blogspot.com]

  […] pathcy myocyte necrosis, edema,scar formation what is the most important sequele of cardiac contrusion HYPOTENSION and ARRHYTMIA investigations of cardaic contusion ECG: pericarditis like ST elevation, RBBB; AV nodal abnormlaities cardiac markers : levels [quizlet.com]

  An electrocardiogram reveals diffused ST elevations and sinus tachycardia. A focused assessment with sonography in trauma (FAST) exam reveals pericardial fluid. [medbullets.com]

  The 12-lead surface ECG showed ST-elevation in lead V 3 and deep T-wave inversions across the precordial leads ( Figure 1 A). [circ.ahajournals.org]

  Initial assessment showed an ST segment elevation on ECG, along with multiple fractures and abdominal injuries. [panafrican-med-journal.com]

• Atrioventricular Dissociation

  One month later he presented with a further complication--complete atrioventricular dissociation--that required a dual chamber pacemaker implantation. [ncbi.nlm.nih.gov]

• T Wave Inversion

  She evolved favorably, with no progression of the pericardial effusion, although electrocardiographically she presented more T-wave inversion in the anterior wall and minimal elevation of ST in I and aVL. [elsevier.es]

  The 12-lead surface ECG showed ST-elevation in lead V 3 and deep T-wave inversions across the precordial leads ( Figure 1 A). [circ.ahajournals.org]

  […] short pulses of ultrasonic beam off structures; may be done as transesophageal to left ventricular procedure with transmitter inserted into esophagus (transesophageal echocardiogram) Electrocardiogram (ECG) Normal PQRST pattern ST segment depression, T-wave [medical-dictionary.thefreedictionary.com]

• Abnormal ECG

  We conclude that young patients with minor blunt thoracic trauma and a normal or minimally abnormal ECG do not benefit from cardiac monitoring. [ncbi.nlm.nih.gov]

  We conclude that young patients with minor blunt thoracic trauma and a normal or minimally abnormal ECG do not benefit from cardiac monitoring. © Williams & Wilkins 1992. All Rights Reserved. [journals.lww.com]

• Ischemic Changes

  […] cardiac injury, tamponade, or cardiac herniation Grade II Blunt cardiac injury with heart block or ischemic changes without cardiac failure Penetrating tangential cardiac wound, up to but not extending through endocardium, without tamponade Grade III [aast.org]

[…] normal ECG changes minor (sinus tach, nonspecific changes) Low risk for significant complications Treatment rarely required Monitoring indicated (telemetry) ECG changes more pronounced (dysrhythmias, etc) Higher risk for complications Treatment may be [fprmed.com]

Treatment & Monitoring What are the treatments for the condition? The goal of treatment is to control the symptoms. Treatments vary depending on how the heart has been damaged. [medicineonline.com]

Additionally, an echocardiogram may reveal abnormalites in the ability of the ventricle to contract (wall motion abnormalities) Treatment Treatment is usually supportive. Patients are watched for 24 hours with continuous ECG monitoring. [medical-dictionary-search-engines.com]

Outcome and prognosis in patients with MC is favorable and, thus, routine cardiac work-up is not indicated. Specific diagnostic and therapeutic measures should be limited to cases where cardiac complications develop. [ncbi.nlm.nih.gov]

Expectations (prognosis) The expectation is that a full recovery will occur. Complications The main complication is that the bruising may lead to myocardial infarction (heart muscle death). [medical-dictionary-search-engines.com]

[…] heart rhythm disturbances, or low blood pressure Pacemaker Supplemental oxygen Various therapies for injuries, such as chest tube placement, drainage of blood from the pericardial sac, or surgery to repair ruptured blood vessels in the chest Outlook (Prognosis [healthmedicinet.com]

[…] low blood pressure Pacemaker (temporary, may be permanent later) Oxygen Other therapies may be used to treat a heart injury, include: Chest tube placement Draining blood from around the heart Surgery to repair blood vessels in the chest Expectations (prognosis [coordinatedhealth.com]

Outlook (Prognosis) Return to top You should recover fully. In non-severe cases, the bruised part of the heart often regains its function without any permanent scarring. [pacificschoolserver.org]

[…] of blunt cardiac trauma patients with frank cardiac rupture often do not even make it to the emergency room Presentation Symptoms chest pain difficulty breathing palpitations lightheadedness Physical exam physical exam findings depend on etiology patients [medbullets.com]

The most common etiologies ( 1 ) are auto-pedestrian accident, CPR, fall from heights>20', and motor vehicle accidents. The majority of patients will have a troponin leak and may have ECG changes. [scmr.org]

[…] bruising of the myocardium-hematoma of the myocardium rare occurance that occurs due to extreme blunt force. describe cardiac contrusion when to suspect cardiac contusion if persistet hypotension and no signs of hemorrhage etiology of cardiac contusion [quizlet.com]

(Etiology) Myocardial Contusions are caused by injuries to the heart muscle that result in bruising. Myocardial contusions can occur from penetrating, non-penetrating, or a combination of both types of chest injuries. [dovemed.com]

The use of Cardiovascular Magnetic Resonance (CMR) can play a major role in diagnosing the etiology of the cardiac abnormalities in this setting. [jcmr-online.biomedcentral.com]

Introduction Clinical definition trauma to the thoracic cage, resulting in cardiac injury Epidemiology location right ventricle is most commonly injured it is right below the sternum aortic valve is the most common valve to be injured risk factors motor [medbullets.com]

A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. ‎ [books.google.it]

Through use of a case study approach, this article demonstrates that a myocardial contusion has many similarities in terms of pathophysiologic changes with that of a myocardial infarction, often confusing symptoms and therefore diagnosis and treatment [ncbi.nlm.nih.gov]

Pathophysiology is unclear, but the timing of the blow in relation to the cardiac cycle may be important. Initial rhythm is usually ventricular fibrillation. [msdmanuals.com]

[…] a spectrum of injuries Mild / minor (transient) Myocardial bruising Temporary dysrhythmias Decreased contractility Serious Ventricular free wall rupture Injury mechanism Direct blows to chest (high-speed impact) MVCs, falls Crush and blast injuries Pathophysiology [fprmed.com]

* cardiac surgery *rarely MI : more often caused by the adm.of CPR pathophysiology of cardiac contrusion deceleration injury that affects the chest wall : direct pressure on the myocardium. intrathoracic pressure ↑, leads to shearing stress. [quizlet.com]

We report a case and review the literature of thromboembolism complicating blunt heart injury, and suggest a protocol to prevent this complication. [ncbi.nlm.nih.gov]

Prevention Keys to preventing myocardial contusion are basic safety precautions, including wearing a seat belt when driving and purchasing an automobile with air bags. Update Date: 4/13/2004 John A. [medical-dictionary-search-engines.com]

Prevention Basic safety precautions are key to preventing myocardial contusion. Wear a seat belt when driving and purchase an automobile with air bags. When working at heights, take appropriate safety precautions. [healthmedicinet.com]