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October 28, 1983

Myocardial Contusion

Author Affiliations

From the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, Calif; and the UCLA School of Medicine, Los Angeles.

JAMA. 1983;250(16):2189-2191. doi:10.1001/jama.1983.03340160075039

MYOCARDIAL contusion was described as early as 1676,1 with the first autopsy-proved case reported by Akenside2 in 1764. Approximately 15% of victims of fatal chest trauma have myocardial contusions demonstrated at autopsy,3 and between 9% and 76%4 of victims of major trauma have been reported to suffer from this disease entity. Contusions to the heart may occur without obvious serious external injury, but the incidence of such is totally unknown. Despite extensive clinical experience and experimental data, we still lack definitive criteria for the clinical diagnosis and are without a readily available, noninvasive, sensitive, and specific diagnostic test to recognize myocardial contusion. Thus, the clinician who deals with seriously traumatized patients is left with the age-old tool, the "index of suspicion," in diagnosing myocardial contusion. The purpose of this article is to review current clinical criteria and modalities commonly used to diagnose myocardial contusion as well