Cardiac Contusion

After direct trauma to the chest wall, there is the potential for the cardiac muscle (myocardium) to have been contused. This may result in reduced function by the formation of an akinetic segment with impairment of electrical conduction through the myocardium resulting in an irregular rhythm.

Recognition of Cardiac Contusion.

If a player presents with central or left sided chest pain after receiving a significant force in same area a cardiac contusion should be suspected. If the pain is increased when taking a deep breath and/or there is clicking of the sternum or left costal margin during inspiration, then the player needs assessment in an Emergency Department. If the player develops an irregular pulse after a blow to the chest wall then they must be transferred urgently to an Emergency Department.

Management of a Cardiac Contusion

• ABCDE
• Oxygen
• Analgesia if trained (not Nitrous Oxide/Entonox)
• Emergency Department assessment as soon as possible