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Cardiac Contusion





  • Trauma patient & need for ATLS approach, other occult injuries

  • Potential emergency with arrhythmias, cardiogenic shock 





  • Early: arrhythmias, myocardial rupture, valvular damage, thrombosis 

  • Late: ventricular aneurysm, dilated cardiomyopathy, pericarditis, ventricular arrhythmias 





  • Hemodynamic instability vs. rapid sequence intubation in trauma setting

  • Hemodynamic instability vs. operative management of other significant injuries





  • Determine extent of myocardial injury (troponin, ECG, echo)

  • Admit to ICU for monitoring

  • Use invasive monitoring as appropriate

  • Manage cardiogenic shock: invasive monitoring, fluid resuscitation, inotropes/pressors, intra-aortic balloon pump 



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