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Cardiac Contusion- Causes, Symptoms, Diagnosis, and Treatment

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A cardiac contusion is a lesion of the cardiac muscle due to a severe injury or trauma. This article is a brief understanding of cardiac contusions.

Medically reviewed by

Dr. Prashant Valecha

Published At November 18, 2022
Reviewed AtJune 11, 2024

Introduction

Cardiac contusion, also known as a myocardial contusion, can be understood as an injury to the muscles of the heart, called cardiac muscles. Cardiac muscles, which are involuntary in nature, serve the vital function of pumping blood to the entire cardiovascular system. These muscles are solely found in the heart. The seriousness of a lesion caused by a cardiac contusion is dependent on how severe the injury is and when the damage took place. A cardiac contusion should not be intermixed or misunderstood as a heart attack.

A heart attack is the result of a lack of blood flow to the cardiac muscles, whereas a cardiac contusion is an injury to the cardiac muscles. Direct trauma to the chest, which is quite blunt in nature, can possibly lead to death because the cardiac muscles get damaged to the extent that repair is impossible. Cardiogenic shock, blood flowing backward, and cardiac failures are some of the notable complications seen in patients who suffer from severe injury or trauma. Post a cardiac contusion, the patient must be conscientiously kept under observation because there are high chances of the patient developing a potentially low blood pressure called hypotension or irregular heart rhythms, called arrhythmia.

How Is Cardiac Contusion Caused?

A cardiac contusion is an uncommon condition but every so often turns into an urgent and far-reaching difficulty due to retardation of the lesion. It is mainly caused due to trauma that has a characteristic blunt force in nature. It should be kept in mind that it takes a lot of power to cause trauma to the heart because the heart is firmly secured within the chest cavity with solid muscles and the presence of a rib cage.

Below are some of the most usual causes that lead to a cardiac contusion:

  • Serious traffic accidents.

  • Crush injuries.

  • Injuries caused due to high-risk sports.

  • Directly getting hit by a fast-moving vehicle.

  • Violent fall from a great height.

  • Explosions.

  • Brutal interpersonal brawls.

  • Mistakes during cardiopulmonary resuscitation.

What Is the Frequency of Cardiac Contusions?

Ten percent or more of patients who have a sternal fracture develop a cardiac contusion. It is uncommon to break the sternum, which is the vertical bone between the ribs. Just 15 percent of cases of major blunt trauma to the chest result in damage to the heart.

What Are the Symptoms of Cardiac Contusion?

The clinically vital sequence of a cardiac contusion is arrhythmia and hypotension. Arrhythmia refers to irregular heartbeats, and hypotension refers to the blood pressure falling down to an abnormal level or low blood pressure. The symptoms of a person suffering through a cardiac contusion are conditional on the gravity of the injury caused. Rarely, a nasty injury can lead to symptoms that are similar to a heart attack.

Signs of a cardiac contusion are the following:

  • Acute chest pain below the ribs that is sharp in nature.

  • Arrhythmia.

  • Feeling weak and lightheaded due to sudden fall in blood pressure.

  • Tenderness on percussion of the chest.

  • Unusual movement of the chest due to fracture of the rib cage.

  • Nausea and vomiting.

  • Difficulty in breathing.

  • Pain while coughing.

  • Bluish discoloration and edema (swelling) at the site of injury.

How to Diagnose Cardiac Contusion?

Diagnosing a case of cardiac contusion remains to be a crucial challenge. Early diagnosis is tremendously the principal key to assessing the acuteness of a cardiac contusion because it can lead to unresolved complications. Rarely does it so happen that a person suffering from cardiac contusion may emerge to have standard electrocardiogram readings and biomarkers, showing no sign of the heart muscles getting mutilated.

Keeping in mind the signs and symptoms, along with the history of trauma or medical history, more advanced medical tests and stronger evaluation of the cardiovascular condition are needed to be done. The signs and symptoms of a cardiac contusion are parallel to that of a heart attack. Also, there are no specific symptoms to diagnose this condition. These are a few of the reasons why it is difficult to identify a case of cardiac contusion.

Thus, despite advancements in medical sciences and investigative techniques, being aware of the trauma or injury that has taken place is the supreme strategy to manage this condition as well as diagnose it. Nevertheless, electrocardiograms (ECG), biomarkers, radionuclide imaging, and physical examination are some of the routine procedures to diagnose a cardiac contusion.

How to Treat Cardiac Contusion?

A case of cardiac contusion varies from person to person depending on severity, being very mild or extremely dangerous. A doctor or a professional healthcare provider, along with their team, evaluates the cardiac lesion for the correct treatment plan. The absence of accurate diagnostic measures leads to identifying the patients at risk, which is the first line of action in the treatment of a cardiac contusion. Patients with instability in their hemodynamics must receive prompt treatment at the earliest. Patients with multiple traumas and lesions also come under the category of foremost concern. Arrhythmias should be controlled within the first few hours of hospital admission. The healthcare provider and the team will be the best people to provide alternative therapies for the heart injury, such as draining the blood pool, placement of chest tubes, etc. Cardiac enzymes are generally used in addition to an ECG to reach a more immediate management plan.

What Is the Duration of Recovery Following a Cardiac Contusion?

Recovering from a cardiac contusion can take many weeks or months, contingent on the circumstances and the extent of the damage.

What Foods Should One Not Eat Because of Cardiac Contusion?

The doctor may advise patients to consume low-sodium foods if they experience heart failure following a cardiac contusion.

What Are Some Ways to Prevent a Cardiac Contusion?

Preventing that can result in a myocardial contusion is essential. While it is not possible to stop every mishap, one can:

  • Operate a vehicle with airbags.

  • When operating a car or riding in one, fasten the seat belt.

  • When performing tasks on a tall structure, wear safety gear.

  • Wear safety gear appropriate to the chosen activity.

Conclusion

Cardiac contusion or myocardial contusion, a result of severe injuries resulting in cardiac arrhythmia and drop in blood pressure, is one of the most talked-about subjects within the trauma communities. It is usually suspected in patients following a car crash, sports injury, or fatal fall from a height that is roughly more than 6 feet. Diagnosis is a challenge since there is no gold standard for diagnosing a cardiac contusion. Still, it is based mainly on the severity of the injury and some clinical findings, such as electrocardiograms and biomarkers. Damage that is least severe in nature does not lead to multiple complications and thus does not require in-depth investigative procedures. Advances in minimally invasive techniques of treatment and management of cardiac contusion are a widely studied topic as of today. Alongside CT (computed tomography) and MRI (magnetic resonance imaging) technologies, there is also a race to find a standard tool for prompt identification of cardiac complications such as cardiac contusions

Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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