[Blunt injury of heart and thoracic aorta]

With growing number and seriousness of traffic accidents and with improving quality of the rescue system, an increasing number of patients with blunt chest injury and injury of intracardiac organs arrive at the hospital facilities. Heart and thoracic aorta can be wounded simultaneously and by similar mechanisms. Myocardial contusion means autoptic or intraoperative finding of necrotic myocardium as a consequence of trauma. The term blunt cardiac injury with description of the anatomic, functional or electrocardiographic abnormality is recommended for the clinical use. Blunt injury may affect any part of the heart and thoracic aorta, most frequently the right ventricle and aortic isthmus. While diagnosis and treatment of serious injury of the heart seems unequivocal, there is no agreement about the appropriate duration and intensity of monitoring, the use of echocardiography and about the assessment of myocardial markers in stable patients with blunt chest injury.