The heart in blunt trauma.

Abstract

DIAGNOSIS of lesions of the heart related to blunt trauma is a challenge, mainly because of confusion about the terms used and the absence of recognized standards. It has been recommended that the term myocardial contusion be avoided and that the term blunt cardiac trauma be used only in the presence of pump failure or malignant cardiac rhythms. These uncertainties make the literature difficult to analyze and compare. The clinician is left knowing that “myocardial contusion” occurs in blunt trauma and may be responsible for significant clinical events (arrhythmias and perioperative hemodynamic instability, including cardiogenic shock and death). Moreover, assessment of the heart in blunt trauma also includes assessment of intracardiac volume, the pericardium, and rare surgical lesions, such as valve rupture, septal defect, and coronary artery lesions. The aim of this Clinical Concepts and Commentary article is to provide the clinician with a brief review of the literature and some recommendations that could be useful in clinical practice.