Symptoms:

A severe myocardial contusion may lead to signs and symptoms of a heart attack.

Pain in the breastbone (sternum) or front of the ribs alerts the physician that there may have been an injury. There may also be a feeling that your heart is racing.

Other symptoms may include:

• Light-headedness
• Nausea or vomiting
• Shortness of breath
• Weakness

Signs and tests:

Physical exams may show:

• Bruises (contusions) or scrapes (abrasions) of the chest wall
• Crunching sensation when touching the skin (crepitus) if there are rib fractures and puncture of the lung
• Fast heartbeat
• Irregular heartbeat
• Low blood pressure
• Rapid or shallow breathing
• Tenderness to the touch
• Visible abnormal chest wall movement from rib fractures (flail segment)

Tests may include:

• Blood tests (cardiac enzymes, such as Troponin or CKMB)
• Chest x-ray
• Electrocardiogram (ECG or EKG), which records electrical conduction in the heart
• Echocardiogram, which records heart wall motion and valve function

These studies may detect:

• Abnormalities in the ability of the ventricle to contract (wall motion abnormalities)
• Fluid or blood in the thin sac surrounding the heart (pericardium)
• Rib fractures, lung or blood vessel injury
• Defect in the electrical system of the heart (bundle branch block or other heart block)
• Fast heart rhythm originating at the sinus node of the heart (sinus tachycardia)
• Ventricular dysrhythmia (abnormal heartbeats starting in the ventricles, or lower chambers of the heart)