IN the present age of high-speed automobile transport and increasing frequency of traffic accidents, one expects to encounter a growing number of chest injuries with cardiac involvement. Those of the direct, penetrating type are readily recognizable, but the nonpenetrating, indirect injuries to the heart may be overlooked. Early diagnosis is essential, not only because specific surgical treatment may be available for cardiac rupture or tamponade, but also because the management of myocardial contusion may be similar to that of myocardial infarction.
The first reported case of myocardial contusion due to nonpenetrating chest injury was described by Akenside1 in 1763. A 14-year-old boy was struck in the chest by a plate. Autopsy six months later revealed extensive necrosis of the left ventricular wall, covered by adherent pericardium. Urbach2 in 1940 found 185 cases of cardiac injury among 1,000 autopsy cases of chest contusion. From 1900 to 1937, 108 cases