Myocardial contusion refers to a bruising of the heart. It is usually due to an injury to the chest wall.
Injuries to the chest wall can be placed into two general groups. Penetrating injuries are wounds in which the chest cavity is pierced. Two examples are knife stabbings and gunshot wounds. Nonpenetrating injuries involve crush injuries, or compression of the chest. This type of injury is often a result of motor vehicle accidents or explosions. Alone or in combination, these forces can cause a myocardial contusion.
A myocardial contusion may have the following effects:
Motor vehicle accidents are a common cause of myocardial contusion. The injury can occur when the driver bangs into the steering wheel. Falls and crush injuries can also cause a contusion. The sudden deceleration caused by these injuries creates sudden tearing forces on the body that contribute to the damage.
Injuries to the heart can be severe even if there is no external sign of chest trauma. Signs and symptoms can include:
Diagnosis of myocardial contusion begins with a medical history and physical exam. Any chest injury, even if it appears to be minor, should be reported to the healthcare provider. Diagnosing myocardial contusion can be very difficult. Many times, problems don't appear for days or even weeks after an injury.
The healthcare provider may order these tests:
Accidents can not always be prevented. However, seat belts used alone or with air bags can help to prevent injury. Also, the right safety equipment should be used for other types of tasks that could result in chest injury. Driving and other potentially dangerous tasks should never be done under the influence of alcohol or drugs. Following sports safety guidelines for children, adolescents, and adults may prevent some injuries.
A person who survives the initial accident may develop complications in the weeks that follow. These can include:
A myocardial contusion is not contagious. It poses no risk to others.
The goal of treatment is to control the symptoms. Treatments vary depending on how the heart has been damaged. Following are some common treatments:
All medicines have associated side effects. Some may worsen arrhythmias and conduction problems. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.
Most people who have a myocardial contusion are able to slowly return to their normal activities after a period of bed rest.
A person who has a myocardial contusion will need follow-up visits to the healthcare provider because complications can appear weeks after the injury. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eric Berlin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:08/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/31/01
Merck Manual 1999
Harrison's Principles of Internal Medicine 1991
Heart Disease: A Textbook of Cardiovascular Medicine, 1980