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Terms in this set (8)
bruising of the myocardium-hematoma of the myocardium
rare occurance that occurs due to extreme blunt force.
describe cardiac contrusion
when to suspect cardiac contusion
if persistet hypotension and no signs of hemorrhage
etiology of cardiac contusion
-blunt forcetrauma :assault,sport injury,animal kick etc
falls: onto chest or even feet (force transmitted to chest and displaces heart against the chest)
car accidents : acceleration/deacceleration injury (hit chest of steering wheel).
* cardiac surgery
*rarely MI : more often caused by the adm.of CPR
pathophysiology of cardiac contrusion
deceleration injury that affects the chest wall : direct pressure on the myocardium. intrathoracic pressure ↑, leads to shearing stress.
RV is most commonly affected due to its position behind the sternum.
LV output ↓ due to reduced preload,reduced LV compliance (may last week)
reduced contractility leads to ↑end diastolic pressure
what is severe contusion characterized by?
pathcy myocyte necrosis, edema,scar formation
what is the most important sequele of cardiac contrusion
HYPOTENSION and ARRHYTMIA
investigations of cardaic contusion
ECG: pericarditis like ST elevation, RBBB; AV nodal abnormlaities
cardiac markers : levels peak rapidly and normalize quizkly (but not good!not used!
ECHO : wall motion abnormalities and RV dilation.
treatment of cardiac contrusion
NSAIDS or gluoccorticoids
monitoring for 24h and serial ECG measurements
careful inotrope support
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