You have been diagnosed with a myocardial contusion (bruise to the heart muscle) following chest trauma
The heart muscle was injured by the force of the impact
Most patients recover fully without lasting problems
Activity restrictions
No strenuous exercise, heavy lifting, or contact sports until cleared by your doctor
Avoid driving if you experience palpitations, dizziness, or chest pain
Gradually return to normal activities as symptoms improve
Medications
Take all prescribed medications as directed
Do not take ibuprofen (Advil, Motrin) or naproxen (Aleve) without physician approval
Acetaminophen (Tylenol) is acceptable for pain management
Follow-up appointments
Follow up with your family doctor or cardiologist within 1-2 weeks
Bring a list of all current medications to your follow-up appointment
A repeat ECG may be required at your follow-up visit
Return to emergency department immediately for
Chest pain or pressure
Palpitations or sensation of irregular heartbeat
Fainting or near-fainting
Shortness of breath at rest or with minimal activity
Lightheadedness or dizziness
Worsening or new symptoms
References
Guidelines and key sources
Eastern Association for the Surgery of Trauma (EAST) guidelines
Clancy K, Velopulos C, Bilaniuk JW, et al. Screening for Blunt Cardiac Injury: An Eastern Association for the Surgery of Trauma Practice Management Guideline. J Trauma Acute Care Surg. 2012
Recommends ECG as initial screening for all blunt chest trauma
Normal ECG + normal troponin: no further cardiac workup required
CT chest with contrast: usually appropriate in blunt thoracic trauma
Cardiac MRI: usually appropriate for persistent unexplained cardiac dysfunction
Landmark reviews
Pretre R, Chilcott M. Blunt Trauma to the Heart and Great Vessels. N Engl J Med. 1997
Comprehensive anatomical and pathophysiological review
Patel KM, Kumar NS, Desai RG, et al. Blunt Trauma to the Heart: A Review of Pathophysiology and Current Management. J Cardiothorac Vasc Anesth. 2022
Current management algorithms including troponin and echo protocols
Van Lieshout EMM, Verhofstad MHJ, et al. Diagnostic Approach for Myocardial Contusion. Eur J Trauma Emerg Surg. 2021
Retrospective evaluation and literature review of diagnostic strategies
Supporting studies
Gao JM, Li H, Wei GB, et al. Blunt Cardiac Injury: A Single-Center 15-Year Experience. Am Surg. 2020
Overall mortality 6.9%; arrhythmia data and structural injury distribution
Jowers J, Van Derveer K, Moore K, et al. Incidence and Risk Factors of Developing a Dysrhythmia After Blunt Thoracic Trauma. J Clin Med. 2025
19.5% dysrhythmia incidence; age >55 and ISS >25 as risk factors
Eghbalzadeh K, Sabashnikov A, Zeriouh M, et al. Blunt Chest Trauma: A Clinical Chameleon. Heart. 2018
Arrhythmia risk factors and need for >5 units blood products as predictor
Nathwani JN, Baucom MR, Salvator A, et al. Evaluating the Utility of High Sensitivity Troponin in Blunt Cardiac Injury. J Surg Res. 2023
High-sensitivity troponin performance characteristics in BCI
Scagliola R, Seitun S, Balbi M. Cardiac Contusions in the Acute Care Setting. Am J Emerg Med. 2022
Historical background, evaluation, and management update
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.