Myocardial contusion in blunt chest trauma: A ten-year review

Abstract

A retrospective review was undertaken of 169 patients admitted to an Intensive Therapy Unit with a major chest injury to determine the incidence, clinical features and outcome of patients with myocardial contusion. This injury occurred in 29 (17%) patients, of whom 24 (83%) had significant cardiovascular complications and five died as a direct result of the injury. The interval between injury and diagnosis was 3.2 +/- 2.3 days (mean +/- SD) from injury and in six patients the diagnosis was made only at necropsy. Increased awareness of myocardial contusion is required for earlier diagnosis and prevention of complications.

Slow progressing cardiac complications—a case report

“…7,11,18,19,23 One explanation of this may be the jarring of the heart that disrupts the vagal sympathetic response, or a direct interference to the neuromuscular mechanisms of the heart resulting in cardiac standstill or ventricular arrhythmias. This information was reviewed in a discussion of animal studies.…”

“…Furthermore, there is great discrepancy in reporting the incidents and implications as to nonpenetrating heart trauma. [4][5][6][7][8][9] The purpose of this paper is to describe an abnormal presentation and development of a complete atrioventricular (AV) block after an automobile accident. The apparent precipitating mechanism was deployment of the air bag against the patient's chest resulting in a blunt force injury, causing a suspected contusion of the heart.…”

The Incidence of Myocardial Contusion in 160 Patients with Blunt Chest Trauma

“…The incidence of myocardial contusion after blunt chest trauma is not clear and has been reported from 8.2 to 75% [21]. Myocardial contusion often remains unnoticed, but complications such as potentially lethal cardiac dysrhythmias, cardiogenic shock, myocardial rupture, myocardial infarction and valvular disruption have been reported [6,7,27].…”

Ventricular tachycardia in an ice-hockey player after a blunt chest trauma

“…During 2 years of follow-up, ICD memory displayed several non-sustained tachycardias, but no ICD interventions occurred so far. From a pathophysiological viewpoint, it must be speculated that the patient had had chest trauma with formation of a scar earlier on and at least two consecutive BCT-induced malignant tachycardias.A severe BCT during physical activity may immediately lead to life-threatening arrhythmias or sudden cardiac death [2,3] in 12 up to 16% of subjects. They are probably due to the timing of the blow into a highly vulnerable phase of ventricular excitability and additional adrenergic stress.…”

“…A severe BCT during physical activity may immediately lead to life-threatening arrhythmias or sudden cardiac death [2,3] in 12 up to 16% of subjects. They are probably due to the timing of the blow into a highly vulnerable phase of ventricular excitability and additional adrenergic stress.…”