Nonpenetrating Traumatic Injury of the Heart

TLDR

Nonpenetrating cardiac trauma is often underestimated because myocardial contusion and pericardial lesions are usually well tolerated, yet it can cause serious sequelae, particularly in previously diseased hearts, and its impact is difficult to assess. The study aims to emphasize that early evaluation and diagnosis of cardiovascular injury in trauma patients are essential, especially now that surgical therapy exists for certain cardiac ruptures. The study found that myocardial rupture of a septum or chamber wall is the most common lesion, while coronary artery thrombosis from nonpenetrating trauma is rare.

Abstract

The misconception that nonpenetrating trauma to the heart is relatively rare, is primarily due to the fact that myocardial contusion or traumatic pericardial lesions are usually well tolerated and the clinical findings transient and often difficult to recognize. However, the sequelae of this type of cardiac trauma may be serious. Therefore, a careful evaluation of every traumatized individual for cardiovascular injury is essential if the more serious complications are to be recognized and treated effectively. The most commonly encountered cardiac lesion at necropsy was myocardial rupture of a septum or a chamber wall. Now that surgical therapy is available for certain types of cardiac rupture, early diagnosis is essential. Thrombosis of a major coronary artery as a direct result of nonpenetrating trauma was not found in this study and is considered rare. Nevertheless, a previously diseased heart appears to be more vulnerable to trauma. Under these circumstances, it is often difficult to assess properly the extent to which trauma may aggravate a pre-existent disease.