What Is Myocardial Contusion?

    A myocardial contusion refers to a bruise of the heart muscle, which can occur with serious bodily injury. According to the National Institutes of Health (NIH), this is most commonly caused:

    • by a car accident
    • by falling from heights greater than 20 feet
    • as a result of chest compressions performed during CPR (NIH, 2012)

    Myocardial contusion should not be confused with infarction. Infarction occurs when the heart is severely damaged as a result of a lack of blood flow to the muscle.

    Cases of myocardial contusion can vary from mild to severe. A medical professional must evaluate each contusion. This condition can lead to complications, particularly in severe cases that are left untreated. See a doctor immediately if you are in a serious accident.

    Symptoms of Myocardial Contusion

    Symptoms can vary depending on when your accident occurred and the severity of the injury. You may experience:

    • extreme pain above the ribs
    • increased heart rate
    • weakness
    • excessive fatigue
    • lightheadedness
    • nausea
    • vomiting
    • shortness of breath

    Any of these symptoms should be evaluated immediately. Symptoms of severe heart contusions may mimic those of a heart attack.

    Causes of Myocardial Contusion

    Bodily injuries and accidents cause contusions of the heart. The heart muscle can be bruised if blunt force or pressure impacts the chest.

    The most common causes of this condition include:

    • falls
    • car accidents
    • being struck by a car
    • cardiopulmonary resuscitation (CPR) injuries

    Diagnosis and Emergency Testing

    Several tests and exams are used to detect a contusion of the heart. First, your doctor will perform a physical exam to check for outward signs of injury near the heart. For example, your doctor may evaluate your chest for bruises.

    Your doctor will also look for:

    • low blood pressure
    • irregular heart rate
    • fast heartbeat
    • irregular breathing

    In some cases, you may experience rib and lung injuries associated with the accident that caused the heart contusion. This will be evident if your doctor detects:

    • a crunching sensation around the ribcage
    • abnormal chest movement when you breathe
    • extreme tenderness on your skin

    Your doctor may use other tools to determine if there are significant injuries to the heart, arteries, ribs and lungs. Additional tests may include:

    • X-ray of the chest
    • computed tomography (CT) scan of heart
    • echocardiogram: to visualize the flow of blood through the heart
    • electrocardiogram: to monitor the heart’s electrical activity
    • complete blood count (CBC): certain enzymes may be present in the blood when the heart muscle and tissues are damaged; CBC can help your doctor determine the extent of the damage

    Treatment of Myocardial Contusion

    The type of treatment you receive depends on your injuries. In some cases, electrocardiograms are performed for 24 hours to monitor the heart on a continuous basis. Emergency treatment may include oxygen if you are experiencing breathing problems.

    You may be referred for additional testing if unusual symptoms are detected. This includes:

    • blood drainage from the heart
    • surgery to repair blood vessels
    • chest tube placement to prevent fluid build-up in the chest
    • placement of a pacemaker to help regulate heartbeat

    Over-the-counter medications, such as acetaminophen and ibuprofen, may also be recommended to help relieve pain. Ask your doctor before use, especially if you’re pregnant or are taking any other pain medications.

    Preventing Myocardial Contusion

    Unfortunately, not all accidents can be prevented and a serious injury can occur without warning. However, there are steps you can take to reduce your risk of accidents and subsequent heart injuries. The NIH recommends the following measures:

    • Take safety precautions, such as wearing a harness, when working at heights.
    • Always wear a seat belt in the car (this includes both drivers and passengers).
    • Choose a car with air bags.

    Outlook for Myocardial Contusion

    Most cases of myocardial contusions are treatable. Mild cases are the most common, and recovery rates are high. However, you may be at risk for further health complications if your injury is severe. Significant injuries can lead to heart failure in the future.