Daily Bolus of LR: Cardiac Contusion

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January 11, 2012 by dailybolusoflr

Cardiac Contusion

 

·         Characterized by intramyocardial hemorrhage, edema and necrosis of myocardial muscle cells

o   Histologically the tissue resembles that of post infarct tissue

·         The most common mechanism is related to car accidents and is secondary to steering wheel trauma and/or rapid deceleration

·         Serum marker is currently the use of troponin, which if not present after 4-6 hours, can reliable rule out contusion

·         ECG findings may be normal or may be non-specific

o   The RV is most commonly injured due to its anterior location, and thus ECG may not show change in electrical activity in minor injuries but may show a transient RBBB in more significant injuries

o   Other findings can include AV blocks, ST elevation or depression or any form of arrhythmia (atrial or ventricular)

·         Echocardiography

o   Most commonly shows localized wall motion abnormality (similar again to infarcted tissue)

·         The reason patients are brought in to the hospital to be monitored when suspicion is high due to mechanism or due to elevated or rising troponin involves the development of ventricular arrhythmias or the development of acute heart failure

·         If a 6 hour troponin is negative, patients can likely be d/c if there are no other active issues

 

Ref: Heart 2003; 89: 485-489

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