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Contusion of Heart (Myocardial Contusion)

What Is a Myocardial Contusion?

A myocardial contusion is a bruise of the heart muscle, which can occur with serious bodily injury. This is most commonly caused:

  • by a car accident
  • by falling from heights greater than 20 feet
  • by receiving chest compressions during cardiopulmonary resuscitation (CPR)

Myocardial contusion shouldn’t be confused with infarction. Myocardial infarction, or a heart attack, occurs when the heart is severely damaged as a result of a lack of blood flow to the muscle.

Cases of myocardial contusion can vary from mild to severe. A medical professional must evaluate each contusion. This condition can lead to complications, particularly if it’s severe and left untreated. See your doctor immediately if you’re in a serious accident.

What Are the Symptoms of a Myocardial Contusion?

The symptoms of myocardial contusion can vary depending on when your accident occurred and the severity of your injury. You may experience:

  • extreme pain above the ribs
  • an increased heart rate
  • weakness
  • excessive fatigue
  • lightheadedness
  • nausea
  • vomiting
  • shortness of breath

Any of these symptoms should be evaluated immediately. The symptoms of severe heart contusions may mimic those of a heart attack.

What Are the Causes of a Myocardial Contusion?

Bodily injuries and accidents cause contusions of the heart. The heart muscle can be bruised if blunt force or pressure impacts the chest.

The most common causes of this condition include:

  • falls
  • car accidents
  • being struck by a car
  • CPR injuries

How Is a Myocardial Contusion Diagnosed?

Several tests and exams are used to detect a contusion of the heart. Your doctor will perform a physical exam to check for outward signs of an injury near the heart. For example, your doctor may evaluate your chest for bruises.

Your doctor will also look for:

  • low blood pressure
  • an irregular heart rate
  • a rapid heartbeat
  • irregular breathing

In some cases, you may experience rib and lung injuries associated with the accident that caused the heart contusion. This will be evident if your doctor detects:

  • a crunching sensation around the ribcage
  • abnormal chest movement when you breathe
  • extreme tenderness on your skin

Your doctor may use other tools to determine if there are significant injuries to the:

  • heart
  • arteries
  • ribs
  • lungs

Additional tests may include:

  • an X-ray of the chest
  • a CT scan of heart
  • an echocardiogram to visualize the flow of blood through the heart
  • an electrocardiogram to monitor the heart’s electrical activity
  • a complete blood count, which can help your doctor determine the presence of certain enzymes in the blood that appear when the heart muscle and tissues are damaged

What Is the Treatment for a Myocardial Contusion?

The type of treatment you receive depends on your injuries. In some cases, electrocardiograms are performed for 24 hours to monitor the heart on a continuous basis. Emergency treatment may include oxygen if you’re experiencing breathing problems.

You may be referred for additional testing if unusual symptoms are detected. This includes:

  • blood drainage from the heart
  • surgery to repair blood vessels
  • chest tube placement to prevent fluid buildup in the chest
  • placement of a pacemaker to help regulate heartbeat

Over-the-counter medications, such as acetaminophen and ibuprofen, may also be recommended to help relieve pain. Ask your doctor before use, especially if you’re pregnant or you’re taking any other pain medications.

What Is the Outlook for People with Myocardial Contusion?

Most cases of myocardial contusions are treatable. Mild cases are the most common, and recovery rates are high. However, you may be at risk for further health complications if your injury is severe. Significant injuries can lead to heart failure in the future.

How Can I Prevent a Myocardial Contusion?

Not all accidents can be prevented and a serious injury can occur without warning. However, there are steps you can take to reduce your risk of accidents and subsequent heart injuries. You should always take safety precautions, like wearing a seat belt in the car and choosing a car with air bags. You should also wear a safety harness if you’re working at height.

Content licensed from:

Written by: Kristeen Moore
Medically reviewed on: Jan 19, 2016: Debra Sullivan, PhD, MSN, RN, CNE, COI

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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