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Myocardial contusion

  • 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)