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Myocardial Contusion, Emergency Medicine

Reviewed 06/2017



  • Also known as blunt cardiac injury

  • Pathologically characterized by discrete and well-demarcated area of hemorrhage

  • Usually subendocardial

  • May extend in pyramidal transmural fashion

  • Most ...


Signs and Symptoms

  • Clinical picture is varied and nonspecific:

    • Chest pain

    • Cardiogenic shock

    • Subtle EKG changes without clinical symptoms

  • Most common sign is tachycardia out of proportion to degre...



Pre-hospital personnel should convey accurate information to emergency department personnel: 
  • Mechanism of injury

  • Motor vehicle status

  • Steering wheel and dashboard damage

  • Use of rest...



  • Adverse outcomes, particularly dysrhythmias, are uncommon but generally occur within 1st 24 hr.

  • No single test or combination of tests will accurately predict which patients can be...

Pearls and Pitfalls

  • Obtain EKG in patients following chest wall trauma.

  • Perform FAST exam on all patients to assess pericardium.

  • External signs of chest wall trauma should increase concern of blunt card...

Additional Reading

  • Clancy  K, Velopulos  C, Bilaniuk  JW, et al. Screening for blunt cardiac injury: An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care...



861.01 Contusion of heart without mention of open wound into thorax 


  • S26.01XA Contusion of heart with hemopericardium, initial encounter

  • S26.11XA Contusion of heart without hemopericardiu...

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