Saturday, February, 11, 2012

Myocardial contusion

Table of Contents

Alternative Names

Blunt myocardial injury


Symptoms

A severe myocardial contusion may lead to signs and symptoms of a heart attack.

Pain in the breastbone (sternum) or front of the ribs alerts the physician that there may have been an injury. There may also be a feeling that your heart is racing.

Other symptoms may include:

  • Light-headedness
  • Nausea or vomiting
  • Shortness of breath
  • Weakness

Signs and tests

Physical exams may show:

  • Bruises (contusions) or scrapes (abrasions) of the chest wall
  • Crunching sensation when touching the skin (crepitus) if there are rib fractures and puncture of the lung
  • Fast heartbeat
  • Irregular heartbeat
  • Low blood pressure
  • Rapid or shallow breathing
  • Tenderness to the touch
  • Visible abnormal chest wall movement from rib fractures (flail segment)

Tests may include:

  • Blood tests (cardiac enzymes, such as Troponin or CKMB)
  • Chest x-ray
  • Electrocardiogram (ECG or EKG), which records electrical conduction in the heart
  • Echocardiogram, which records heart wall motion and valve function

These studies may detect:

  • Abnormalities in the ability of the ventricle to contract (wall motion abnormalities)
  • Fluid or blood in the thin sac surrounding the heart (pericardium)
  • Rib fractures, lung or blood vessel injury
  • Defect in the electrical system of the heart (bundle branch block or other heart block)
  • Fast heart rhythm originating at the sinus node of the heart (sinus tachycardia)
  • Ventricular dysrhythmia (abnormal heartbeats starting in the ventricles, or lower chambers of the heart)

Review Date: 04/13/2010
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)