Definition of the Disorder
A cardiac contusion is a bruise to the cardiac muscle. It is also sometimes called a myocardial contusion, where the term myocardial refers to the muscular cardiac tissues. A bruise to the cardiac muscle would seem to be a difficult injury to experience, insofar as one’s heart is seemingly well protected by the bones and muscles of the rib cage. Cardiac or myocardial contusions most often occur as a result of a massive chest injury. One of the most common causes of an extensive chest trauma is a car accident. In fact, most bruises of this type happen in car accidents, and most often involve the driver of the vehicle, since the injury occurs when the driver’s chest impacts against the steering wheel.
Any severe blow to one’s chest could conceivably cause this type of bruising. A blow to the chest during an athletic event could be a cause, although having such an injury during a sporting event is somewhat of a rarity. Contusions involving the cardiac muscles have even been caused by attempts at cardiopulmonary resuscitation, at which time a great deal of pressure can sometimes be applied to the chest. Falls also can account for this type of injury. A contusion is highly unlikely to be due to simply falling down, but could be caused by falling from a height.
Symptoms of Cardiac Contusion
Insofar as the symptoms of myocardial contusions are concerned, the pain that may be experienced could in many instances be masked by the pain experienced from any kind of massive chest injury, and it would not always be readily apparent whether or not one’s heart suffered any damage. Pain caused by myocardial contusions would usually be felt near the breastbone or sometimes in front of the ribs. Upon attempting to make a proper diagnosis, an attending physician will usually be compelled to question a patient about any other symptoms he or she might be experiencing. The most common symptoms would be a racing heartbeat, an irregular heartbeat or palpitations, nausea, lightheadedness, or a shortness of breath, all indications that one’s heart might be laboring. The attending physician would naturally look for other signs of injury that might give an indication that the trauma experienced may have gone deep enough to in some way impact the heart.
Tests Conducted in Diagnosing Cardiac Contusion
If an initial examination in any way suggests that a contusion may have occurred, there will usually be a battery of tests conducted to assess both the performance and the condition of the blood-pumping organ. These tests would most likely include:
- The familiar electrocardiogram, or ECG, which can usually verify if the heart has in some way been damaged and whether it is beating normally or not.
- An echocardiogram test is an ultrasound test that is used to monitor the movement of the walls of the heart chambers as well as that of the cardiac valves. The usual method employed involves placing a transducer against the chest near the breastbone. The transducer sends a high-frequency sound wave towards the heart and picks up the returning echo that, with instrumentation, will yield an image of the valves and muscles in motion.
- A chest x-ray may also be taken. While valuable information can often be obtained from an x-ray, the ECG and echocardiogram usually provide more detailed information.
- Blood tests, or CPK-MB tests, are taken to detect the levels of certain cardiac enzymes. High levels of these enzymes often indicate that cardiac damage has occurred. These tests are normally conducted to determine the amount of damage that may have occurred due to a heart attack and also a myocardial contusion.
In some instances, surgery may be necessary to treat this type of injury, but a surgical approach will generally be not needed unless one’s blood-pumping organ has been damaged severely enough to require emergency repair. Treatment of a heart contusion typically consists of rest and cardiac monitoring while under the supervision of a cardiologist. Cardiac monitoring is generally short term, being done while a patient is under intensive care or in recovery. Oxygen therapy, more commonly used in the treatment of congestive heart failure, may also be used in treating a contusion. Oxygen levels in the blood, or, more precisely, oxygen saturation levels, will often be measured from time to time. This is done by attaching a measuring device to a patient’s fingertip, a painless procedure. Medications will sometimes be prescribed to help prevent the occurrence of abnormal heart rhythms. Pain medication may also be needed, but will no doubt be required in any event if there have been severe injuries to the ribs or chest. In most cases, rest is what a bruised heart muscle normally needs more than anything else in order to heal.