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Myocardial Contusion Due to Ballistic Impact Force
Shaikh B Iqbal1, Ahmad Amin2, Andrew P Hill3
1Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA.
Background:
Myocardial contusion typically occurs from blunt cardiac trauma often due to motor vehicle collisions and falls from a significant height. Gunshot wounds may cause compression and stretching of tissue from the sonic pressure waves that precedes the bullet. Myocardial contusions are difficult to accurately diagnose due to lack of standardized approach to their evaluation and variability in their presentation.
Case:
We present 3 unique cases of myocardial contusion following gunshot wounds: a 40-year-old man with multiple gunshot wounds to the left chest and buttocks, a 28-year-old man with a gunshot wound to the chest, and a 25-year-old man with multiple gunshot wounds to the left upper chest, left arm, and right hand. All cases presented with ST-segment elevation and elevated high-sensitivity troponin I.
Discussion:
Myocardial contusion has a diverse presentation and management should be focused on treating complications of cardiac injury and ruling out more serious complications requiring emergent surgical management.
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