Anesthesia Considerations 

Cardiac Contusion

 

 

Considerations

 

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

• Potential emergency with arrhythmias, cardiogenic shock 

 

 

Complications

 

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

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

 

 

Conflicts

 

• Hemodynamic instability vs. rapid sequence intubation in trauma setting

• Hemodynamic instability vs. operative management of other significant injuries

 

 

Optimization/Goals

 

• 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