Myocardial contusion

Definition

Myocardial contusion is a "bruise" of the heart muscle.

Alternative Names

Blunt myocardial injury

Causes, incidence, and risk factors

The most common causes are:

• Cardiopulmonary resuscitation (CPR)
• Falls from heights greater than 20 feet
• Motor vehicle accidents (usually due to the driver coming into contact with the steering wheel)

Symptoms

Pain in the breastbone (sternum) alerts the physician that there may have been an injury. Usually there are no symptoms other than a feeling that your heart is racing.

Signs and tests

Signs include:

• Abnormalities in the ability of the ventricle to contract (wall motion abnormalities)
• Defect in the electrical system of the heart (right bundle branch block)
• Fast heart rhythm originating at the sinus node of the heart (sinus tachycardia)
• Ventricular dysrhythmia

Tests include:

• Electrocardiogram (ECG)
• Echocardiogram

Treatment

Treatment is usually supportive. Patients are watched for 24 hours and continually monitored by ECG.

Some patients may need pain medication for pain in the breastbone (sternum).

Expectations (prognosis)

You should recover fully.

In non-severe cases, the bruised part of the heart often regains its function without any permanent scarring.

Complications

The main complication is that the bruising may lead to heart attack. This may cause long-term weakness in the ability of the heart to contract.

Abnormal heartbeats and conduction of electrical signals (arrhythmias) can occur. These can be serious.

Prevention

Basic safety precautions are keys to preventing myocardial contusion. Wear a seat belt when driving and purchase an automobile with air bags.