Arrhythmias Following Cardiac Contusion

Presentation and Diagnosis

Patients with cardiac contusion may experience dyspnea or shortness of breath from concurrent heart failure, pulmonary contusion, or hemothorax, as reported by the European Heart Journal and the Journal of the American College of Radiology 1, 2
Hemodynamic instability can manifest as persistent hypotension (systolic blood pressure <90 mm Hg) despite fluid resuscitation, according to the Journal of the American College of Radiology 1
A 12-lead ECG is mandatory to identify rhythm disturbances, conduction abnormalities, or signs of ischemia, as recommended by the European Heart Journal and the Journal of the American College of Radiology 1, 4
Echocardiography (transthoracic or transesophageal) detects wall motion abnormalities, valve injuries, pericardial effusion, and ventricular dysfunction, as reported by the European Heart Journal and the Journal of the American College of Radiology 1, 2

Patients at highest risk for symptomatic arrhythmias include those with sternal fractures combined with ECG changes or elevated troponins, as reported by the Journal of the American College of Radiology 1
The American College of Radiology recommends that patients with hemopericardium or cardiac chamber rupture be considered high-risk for symptomatic arrhythmias 1