From the Guidelines
Damage control thoracotomy is the treatment for cardiac contusion (myocardial contusion) in severe cases.
Treatment Approach
- The treatment approach for cardiac contusion involves a case-by-case basis, considering the severity of the injury 1.
- In severe cases, such as those with progressively massive hemorrhage or severe heart contusions, damage control thoracotomy is recommended.
- The anterolateral left thoracotomy approach is generally used as an initial incision, which can be extended to become the clamshell approach if necessary 1.
Severity Assessment
- The decision to perform a damage control thoracotomy depends on the severity of the cardiac contusion and associated injuries, such as tracheal and bronchial injuries 1.
- A thorough assessment of the patient's condition is crucial to determine the appropriate treatment approach.
From the Research
Treatment for Cardiac Contusion (Myocardial Contusion)
The treatment for cardiac contusion (myocardial contusion) typically involves observation and monitoring for arrhythmias, as well as supportive care to manage any related complications.
- Patients with myocardial contusion should be observed for 24 to 48 hours for arrhythmias 2.
- Diagnostic work-up should always include electrocardiogram and cardiac enzymes, and may include echocardiography if specific disorders (ie, tamponade or valvular disorders) are suspected 2.
- Many other significant forms of blunt cardiac injury require surgical intervention 2.
- In stable patients, myocardial contusion does not necessitate intensive care unit monitoring 3.
- Patients with normal electrocardiograms (ECGs) and biomarker tests can be safely discharged, while those with abnormal test results may require further evaluation with echocardiography and advanced measures 4.
Monitoring and Care
- Patients with myocardial contusion should be carefully monitored for cardiogenic shock or arrhythmia 4.
- Surgical procedures requiring general anesthesia can be performed in patients with myocardial contusion, with no significant arrhythmias developed under general anesthesia 5.
- The level of care for patients with myocardial contusion should be determined based on the severity of the injury and the presence of other organ system injuries 3.