CONTUSIO CORDIS - DIAGNOSED TOO RARELY

Background: Myocardial contusion is the most common injury caused by b lunt chest trauma. Cardiac contusion often does not produce significan t symptoms and, thus, remains unrecognized. Case Report: A 29-year-old professional ice-hockey player presented with a tachyarrhythmia two d ays after having suffered a thoracic trauma. Two weeks prior to admiss ion he had had an influenza-like infection. Non-invasive diagnostic me thods were normal. However, cardiac catheterization revealed an kinesi s of the left ventricular anterior wall in the absence of any coronary artery lesions. Endomyocardial biopsy did not show any evidence of my ocarditis but erythrocyte extravasations in the endo- and myocardium, thus, confirming the diagnosis of cardiac contusion. Three months late r, left ventriculography and coronary angiography did neither demonstr ate any abnormalities of ventricular contraction nor of the coronary v essels. Conclusion: Myocardial contusion is still being rarely diagnos ed after sporting accidents. Cardiac contusion is a benign disorder in most patients. However, due to its potentially lethal outcome and as sequelae may present later after the trauma, early and precise diagnos is is important, both from the clinical point of view as well as for f uture insurance requests. Thus, invasive diagnostic techniques should be performed when non-invasive examinations do not provide a conclusiv e diagnosis.