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Blunt Cardiac Injury.


Singh S1, Angus LD1.


StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018-.
2018 Nov 14.

Author information

Nassau University Medical Center


Cardiac contusion is a misnomer that is used to reflect injury to the heart after blunt chest trauma.[1]. Histologically, it was characterized by a contused myocardium, hemorrhagic infiltrate, localized necrosis, and edema. Because of the term's ambiguity in describing a spectrum of myocardial injuries secondary to blunt trauma, "cardiac contusion" is now termed "blunt cardiac injury" (BCI). This is the term trauma experts agree is more appropriate since it encompasses the various types of cardiac injuries seen after blunt chest trauma.[2][3] BCI Injuries can range from clinically silent, transient arrhythmias to fatal cardiac rupture.[4]. Significant BCI usually occurs from high-impact trauma from motor vehicle accidents (50%), pedestrian struck by motor vehicles (35%), motorcycle crashes (9%), and falls from significant heights (6%).[5][6][7]. Diagnosing BCI can be challenging as there is no accepted gold standard diagnostic testing. The injury can be even more complicated in a patient with multiple traumas. The reported incidence of cardiac injury following blunt chest trauma is in the range of 8% to 76%; this reflects the lack of standardized diagnostic criteria.[7]  In essence, myocardial tissue damage is the only way that BCI can be confirmed, either at surgery or autopsy.[8] In the vast majority of cases, however, this option is not available, and the clinical and diagnostic tools available in our armamentarium are variable and nonspecific. More importantly, in the absence of severe arrhythmia and hemodynamic instability, the significance of BCI becomes more questionable despite the results of noninvasive studies.[5][9] In the setting of blunt trauma, a high, clinical suspicion for BCI is warranted, and if suspicion is high enough, patients should be monitored for adverse sequelae since there are no pathognomonic clinical signs or symptoms that correlate with the risk of cardiac complications.[5][10][11]. Indeed, it is the sequelae of BCI that is of importance and not necessarily its label.

Copyright © 2018, StatPearls Publishing LLC.

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