A health condition that often occurs due to car crashes and falls, and causes a bruise on the heart muscle, is called a myocardial contusion (also called cardiac contusion). In other words, myocardial contusion appears when something hits the chest hard but does not go through the skin. One of the most common causes of this condition is a car crash.
Generally, cardiac contusion happens in about 10% of people with a sternal fracture. Approximately 15% of people with major blunt trauma to the chest also experience myocardial contusion.
What is The Difference between Myocardial Contusion and Cardiac Tamponade?
While both conditions can cause similar symptoms, they are different conditions. For instance, cardiac contusion occurs when a bruise negatively affects the heart muscle, but in people with cardiac tamponade, there is a collection of fluid in the sac around the heart muscle. Excessive fluids often put extra pressure on the heart, causing symptoms.
What Are The Symptoms of Myocardial Contusion?
Sometimes, this condition does not cause any symptoms (especially mild forms), but in more severe cases, it may lead to the following symptoms. Examples include:
- A feeling like you have a heart attack (myocardial infarction)
- Lightheadedness
- Stomach upset
- Dyspnea (shortness of breath)
- Heart palpitations
- Pain in the ribs
If any of the symptoms listed above occur, immediately contact your physician.
Causes
In most cases, people experience cardiac contusion due to car accidents, but it may also happen due to other causes. Examples include:
- Injury that occurs while playing sports
- A fall of 20 feet or more
- Cardiopulmonary resuscitation (CPR)
- Getting hit by a car
Moreover, there are some clinical indications of high risk, including rib or sternal fractures and arrhythmias (irregular heart rhythms). For more details, discuss it with your doctor.
Complications
If you develop a moderate to severe myocardial contusion, it may also lead to certain complications, especially if the condition is left untreated. Check some examples below:
- Cardiac tamponade
- Myocardial rupture
- Death (without warning)
- Arrhythmia (irregular heart rhythm)
- Heart failure
- Cardiogenic shock (a sudden drop in blood pressure)
- PVCs (premature ventricular contractions)
- Tachycardia (fast heartbeat)
- Atrial fibrillation (AFib)
- Heart blocks
- Pulmonary congestion
- Trouble breathing
- Septal rupture
- Heart attack (myocardial infarction)
- Mural thrombi – This complication occurs when a blood clot breaks off from the bruised heart chamber. It can cause stroke and pulmonary embolism.
This document does not contain a full list of complications, but you can talk with your physician about measures to reduce the risk or even prevent them. In addition, doctors may recommend some tips that often help reduce the risk of a myocardial contusion. Examples include driving a car that has airbags, using your seatbelt, getting protective equipment when working on a tall structure, wearing protective gear for your sport, and others.
Diagnosis
Sometimes, it is difficult to diagnose this condition because there are no obvious signs of trauma, and the affected person does not have any symptoms. Usually, when a myocardial contusion occurs, doctors may find the following things during a physical examination and testing. For example:
- Signs of broken ribs
- Hypotension (low blood pressure)
- Abnormal heartbeat
- Fast breathing
- Scrapes or bruises on the chest
Check below some tests often done to confirm or exclude myocardial contusion:
- Chest X-ray and CT (computerized tomography) scans
- Echocardiogram
- Heart MRI (magnetic resonance imaging)
- Electrocardiogram (ECG or EKG) to measure the electrical activity of the heart
- Blood tests for a cardiac enzyme (including troponin I and troponin T)
Treatment
In general, there are no specific treatments for myocardial contusion. That’s why the treatment goal is to relieve the symptoms, prevent serious complications, and improve your quality of life. Check some general options below:
- Blood pressure medicines that often help the heart work efficiently
- Pericardiocentesis
- Medicines or temporary devices that help with cardiogenic shock
- Surgery to repair a myocardial rupture (rarely)
In more severe cases, you will receive:
- IV (intravenous) fluids in the arm or hand
- Supplemental oxygen
- Medicines to treat arrhythmia, hypotension, and pain
- Temporary pacemaker
- A chest tube to drain excess fluid from around the heart muscle.
If tests confirm you have a myocardial contusion, you may need to stay a few days in the hospital.
Frequently Asked Questions
How long does it take to recover from a cardiac contusion?
Commonly, people get rid of this condition within several weeks, but in more severe cases, it may take a few months to recover completely.
How soon after treatment will I feel better?
Usually, IV medications start working quickly, but medical devices that help your heart function properly often improve your situation right away.
Who does a myocardial contusion affect?
While this condition can affect anyone, the following people are at increased risk. Examples include:
- Teenagers and young adults who get hurt while engaging in an extreme sport
- Older adults (over 80 years old) who get chest injuries (such as during a car accident)
- Middle-aged people who fall while working on a high construction site
Can a myocardial contusion be life-threatening?
Yes. While many cases are mild and resolve without long-term problems, severe myocardial contusions can lead to life-threatening complications such as heart failure, cardiogenic shock, dangerous arrhythmias, or cardiac rupture. Prompt medical evaluation is important after any significant chest injury.
Can myocardial contusion occur without a broken rib or sternal fracture?
Although rib and sternal fractures increase the risk, a myocardial contusion can occur even when no bones are broken. A strong blunt impact to the chest may still bruise the heart muscle.
How is myocardial contusion different from a heart attack?
A myocardial contusion is caused by trauma to the chest that bruises the heart muscle, whereas a heart attack usually occurs when blood flow through a coronary artery becomes blocked. However, both conditions can cause chest pain, shortness of breath, and abnormal heart rhythms.
What should I avoid during recovery from a cardiac contusion?
Your doctor may recommend avoiding strenuous physical activity, heavy lifting, and contact sports until your heart has healed. Following your healthcare provider’s instructions can help prevent complications and promote recovery.
Can children develop myocardial contusion?
Yes. Children can experience myocardial contusion after a significant chest injury, such as those caused by sports accidents, bicycle crashes, falls, or motor vehicle collisions. Medical evaluation is recommended whenever a child experiences a serious blow to the chest.
Will I need follow-up appointments after leaving the hospital?
In many cases, yes. Follow-up visits allow your doctor to monitor your recovery, assess heart function, check for persistent arrhythmias, and ensure that no delayed complications develop.
Can a myocardial contusion cause permanent heart damage?
Most people recover completely without lasting effects. However, severe cases may result in long-term heart rhythm abnormalities or reduced heart function. The risk of permanent damage is generally higher when the injury is extensive or when treatment is delayed. Ask your healthcare provider if you have any other questions.
