A Bruised Heart Can Be Fatal

A "broken" heart can get you down, but a "bruised" heart can be fatal.

Each year some 150,000 persons suffer a bruised heart – medically termed a contusion – and most cases go undetected, says Dr. Donald B. Doty, a professor in the University of Iowa Carver College of Medicine and a heart surgeon at The University of Iowa Hospitals and Clinics.

Auto accidents with impact from the steering wheel are the most common cause of this type of injury. Other causes include animal kicks, falls, impact from a projectile or blast injuries.

"Associated injuries often make the diagnosis of a cardiac contusion difficult," Dr. Doty says. "Attention is turned to obvious injuries and the contusion may not be initially considered. An index of suspicion must be maintained for patients with the appropriate mechanism of injury."

Dr. Doty says that physicians, often in the ER, will run a variety of tests to confirm the diagnosis. The signs may include abnormal electrocardiogram readings and lab tests that show elevated readings for serum cardiac troponin. He adds that cardiac echocardiography also may be used to support the diagnosis. "In hemodynamically-stable patients with a normal ECG and normal cardiac troponin, the diagnosis may be effectively excluded," Dr. Doty says. He adds that elevated troponin alone however, does not definitively make the diagnosis. These patients require cardiac monitoring for at least an additional 24 hours.

To help detect this kind of heart damage, Dr. Doty and other physicians have developed a technique that uses a tracer substance that concentrates in the damaged heart tissue and can quickly give them a "picture" of the seriousness of the injury.

Donald B. Doty, MD
Professor of Surgery
University of Iowa Health Science Relations