A myocardial contusion is a bruise to your heart muscle. It's caused by blunt force to your chest. It may tear the wall of your heart or damage your heart valve.
What Causes a Myocardial Contusion?
A myocardial contusion happens as a result of blunt force trauma. Your heart is well-protected by the bones of your chest, so it takes a lot of force to damage it. The most common causes are:
- Falling from a height greater than 20 feet
- Car crashes
- Chest compressions performed during cardiopulmonary resuscitation (CPR)
- Getting hit by a car
- Sports injuries
- Crush injuries
What Are the Symptoms of a Myocardial Contusion?
A myocardial contusion can cause different symptoms. Some possible symptoms include:
How Is A Myocardial Contusion Diagnosed?
Your doctor will listen to your symptoms and do a physical exam. When they're doing an exam, they'll look for:
Your doctor may also order tests to help confirm a diagnosis, including:
- Blood tests
- Chest x-ray
- Computed tomography (CT) scan
- Echocardiogram, which shows the pumping action of your heart
- Electrocardiogram, which shows your heart's electrical activity
These tests will help your doctor determine if your heart has been damaged and how it needs to be treated. Myocardial contusions can range from mild to severe.
Possible Complications of a Myocardial Contusion
Some complications of myocardial contusion show up soon after you're injured. These are called early complications. These can include:
- Irregular heartbeat
- Rupture of the heart wall
- Rupture of the ventricular septum, which is the wall separating the two lower chambers of the heart
- Valvular insufficiency, which is when your heart valve doesn't close completely and blood flows backward
- Blood clot in your heart
- Myocardial infarction, which is commonly called a heart attack
Some complications may not show up until a while after your injury. These can include:
Risks Associated with a Myocardial Contusion
A particular type of injury that results from blunt trauma to the chest is commotio cordis. This type of injury doesn't cause direct damage to the heart muscle. Instead, blunt trauma, such as the kind that occurs when the left side of the chest is hit with a baseball, interrupts the heart's rhythm. This causes sudden cardiac arrest in an otherwise structurally normal heart.
Commotio cordis is a leading cause of death in young athletes. It happens most often in children. It could happen to children more often because they have a thinner chest wall or because they're more likely to play sports that result in this type of trauma. Commotio cordis should be treated immediately with an automated external defibrillator (AED).
Some tips to prevent and improve survival rates of commotio cordis include:
- Children should use age-appropriate safety baseballs.
- Children should use chest protectors.
- Rules and coaching techniques should focus on reducing chest blows.
- Coaches and other adults should be trained to recognize commotio cordis and how to resuscitate players.
- All sporting arenas should have an accessible AED.
- If possible, a healthcare provider should be available during sporting events to advise and assist in emergencies.
How Is a Myocardial Contusion Treated?
You will probably be closely monitored for at least 24 hours. You will probably have a continuous electrocardiogram done to check your heart function. Other treatment options may include the following, as needed:
- Medicine to relieve pain
- Medicine for low blood pressure
- Medicine for a heart rate disturbance
- Chest tube
- Drainage of blood around the heart
- Surgery to repair your heart
Preventing Myocardial Contusion
Not all myocardial contusions can be prevented. However, the following tips may help:
- Always wear a seatbelt.
- Choose a car with airbags.
- Follow safety regulations when working at heights.
- Wear protective equipment during sports.