Cardiac Contusion

Question 1

(1) Blunt force trauma to the chest can cause myocardial contusion and necrosis.

(2) Myocardial tissues, once contused, begin to swell, causing pressure on capillaries and decreased blood flow to the injured myocardium, which then can lead to necrosis.

(3) Commonly caused by high-speed MVA, steering wheel in motor vehicle accidents, and other blunt force trauma.

Answer 1

Pathophysiology: Cardiac Contusion.

Question 2

(1) Commonly asymptomatic except for chest wall pain.
(2) Severe anterior chest injury (broken ribs, chest wall contusion with ecchymosis).
(3) Tachycardia is disproportionate to the degree of trauma.

Answer 2

Symptoms/Physical Findings: Cardiac Contusion.

Question 3

(1) EKG: Sinus tachycardia is the most common finding. Look for possible life threatening arrhythmias.
(2) CXR: Look for rib fractures, pulmonary contusion, and broken collar bone.

Answer 3

Labs/Studies/EKG: Cardiac Contusion.

Question 4

(1) ABC, IV, O2, Monitor
(2) Analgesics for pain control
(3) Monitor for 4-6 hours, if there is no hemodynamic instability apparent, repeat EKG in 24 hours.
(4) Diagnose and treat any cardiac arrhythmias accordingly.

Answer 4

Treatment: Cardiac Contusion.

Question 5

(1) Pain control with analgesics
(2) Monitor
(3) If suspect cardiac or pulmonary contusion, then need to transfer to a higher level of care.

Answer 5

Initial Care: Cardiac Contusion.

Question 6

AMI
Cardiac Dysrhythmias
Pericardial effusion
Pericardial Tamponade
Aortic dissection
Pericarditis

Answer 6

Complications: Cardiac Contusion.