CARDIAC CONTUSION

PRESENTED
MR. BAKO THADDEUS.
 OUTLINE

• INTRODUCTION
• DEFINATION
• INCIDENCE
• CAUSES
• SIGN AND SYMPTOMS
• INVESTIGATIONS
• MANAGEMENT
• PREVENTION
• PROGNOSIS
 INTRODUCTION

• Cardiac contusion is a well defined pathological entity following

deceleration trauma.
• Severe contusion results in ventricular dysfunction and malignant
arrhythmia.
• Diagnosis is base on ECG findings
• Diagnosis in less severe cases is more difficult.
 DEFINITION AND TYPES

• Cardiac contusion can be defined as the bruise of the heart muscles

following a deceleration trauma.
• Mild cardiac contusion is just a bruised of the myocardium without
further injury .
• Severe cardiac contusion may result to tear of the cardiac muscles,
septum, valve etc. it makes it difficult for the heart to function normal
again.
 INCIDENCE
• Cardiac contusion can occur to both male and female
• But male are at the higher risk of getting cardiac contusion than
female, because male are prone to associated injury work eg sporting
activities traveling and enjoyed sitting in front of the vehicle without
minding their seatbelt.
• Children are less affected
• 60 percent of patient with chest injury had severe or mild cardiac
contusion base on ECG result.
 CAUSES
• RTA
• Sporting activities
• Fall from height
• Industrial accident
• Domestic accident
• Assault
• Communal clash
• CPR
 SIGN AND SYMPTOM
• Chest pain
• Tenderness
• Headache
• Nausea
• Vomiting
• Shortness of breath
• Tachycardia
• Irregular heartbeat
• Low blood pressure
 PHYSICAL EXAMINATION
• Abnormal chest wall, may be due to rib fracture.
• Bruise around the chest wall.
• Associated with puncture of the lungs.
 INVESTIGATIONS
• Blood for PCV
• FBC
• RBS
• EUCR
• CHEST X-RAY
• CT SCAN OF THE CHEST
• ECG
• ECHOCARDIOGRAM.
 TREATMENT
• Treat as an emergency
• Admit patient in crash room
• Secure IV LINE immediately and obtained blood sample
• Check for CAB but don’t do CPR
• Connect patient to cardiac monitor
• Check for injury, bleeding and apply firm dressing
• Catheterised patient
• Administer oxygen prn.
 MEDICAL MANAGEMENT
• Administer pain relieve eg im tradyl 100mg 12hrly for 24hrs
• Im diclofenac 75mg 12hrly for 24hrs
• Administer antibiotic eg iv ceftriazone 2gst then 1g 12hrly for 24hrs
• Iv flagyl 500mg 8hrly for 24hrs.ect.
 NURSING MANAGEMENT
• Admit patient on cardiac bed.
• Monitor vital sign closely
• Monitor intake and output
• Monitor under water seal drainage
• Ensure right medication
• Dressing prn
• Monitor oxygen flow.
• Reassure patient and relative
 SURGICAL MANAGEMENT
• Chest tube placement
• Wound exploration
• Repair heart, blood vessel, rib fracture
 PREVENTION
• Always be on seatbelt when driving.
• Choose a car with airbags.
• Take steps to ensure safety while working on height.
• Always wear PPE when performing sporting activities or industial
work.
PROGNOSIS
• PEOPLE WITH MILD MYOCARDIAL CONTUSION WILL RECOVER
COPMPLETLY MOST OF TIME.
• SERIOUS HEART INJURY WILL INCREASE RISK FOR HEART FAILURE OR
HEART RHYTHM PROBLEMS.
• HEALING IS 2 TO 4 WEEKS.
 ASSIGNMENT
• Mr. Lobito had a road traffic accident while driving home from office after a
hectic work. He was rushed to accident and emergency unit where a diagnosis
of cardiac contusion was made.

• With the aid of a well labelled diagram, describe the macroscopic structure of
the heart.
• Outline four sign and symptoms of cardiac contusion.
• Utilizing the nursing care plan. Identify and solve in order of priority three [3]
nursing diagnosis of Mr Lobito within the first 24hrs of admission.
• List six [6] preventive measures of cardiac contusion.
• List four [4] complications of cardiac contusion.
• THANKS FOR LISTENING.