CONTRARY to accepted belief, death from myocardial contusion is not rare. The lesion is merely infrequently recognized. Sudden unexpected death may offer the first clue that a heart injury exists. There are very practical reasons for recognizing these injuries, since serious errors in management of both the cardiac and associated injuries may be avoided if the cardiac lesion is known to exist. Also, the increasing medicolegal implications make it imperative that physicians become acquainted with this problem.
We choose to deal only with myocardial contusion. Most reports are concerned with all forms of cardiac damage associated with nonpenetrating injury. Our experience and the recorded experience of others9,10,23 indicate that valvular injury, septal perforation, and myocardial rupture have little in common with contusion except etiology. The exception to this general statement is the possibility that cardiac tamponade may occur after any cardiac injury. The hemodynamic changes associated with tamponade are