Heart injury

Classification according to ICD-10
S26.0	Injury to the heart with hemopericardium
S26.8	Other injuries to the heart
ICD-10 online (WHO version 2019)

Heart injuries caused by external force can occur in connection with any chest injury (chest trauma ). In the case of an open thoracic trauma with opening of the chest cavity as a result of an accident, gunshot or stab wounds, open heart injuries can also occur, which usually ends fatally in a short time.

In the case of a closed thoracic trauma with cardiac involvement, a distinction can be made between three degrees of severity, although these are not clearly defined. The distinction is rarely used in everyday medical practice. Occasionally, all three degrees of severity are summarized under the term commotio cordis or a distinction is only made between commotio cordis without and contusio cordis with visible changes in the heart.

Commotio cordis

The term commotio cordis or "heart shock" refers to blunt heart injuries that only lead to temporary functional disorders without visible changes. Cardiac arrhythmias are common, but usually do not require treatment. In some cases, however, in the can vulnerable phase incident premature lethal ventricular fibrillation trigger. While this possible cause of sudden cardiac death was thought to be extremely rare for many years, it is now believed to be a major cause of sudden death, especially in boys aged 5 to 18 years.

Contusio cordis

The contusio cordis or "heart bruise" (caused by a shock wave over the chest organs) can lead to bleeding into the heart muscle ( myocardium ) and rarely to a pericardial tamponade , which can be fatal without immediate treatment. Arrhythmias are common.

Compressio cordis

With the Compressio cordis or "heart contusion" there is bleeding in the myocardium and possibly also the pericardium . The sudden increase in pressure in the heart can tear off parts of the heart valves and papillary muscles as well as rupture the heart wall or the aorta, resulting in a fatal outcome.

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↑ LA Geddes, RA Roeder: Evolution of our knowledge of sudden death due to commotio cordis. In: Am J Emerg Med. (2005); 23, pp. 67-75. PMID 15672341 .
↑ MS Link et al .: What is commotio cordis? In: Cardiol Rev. (1999); 7, pp. 265-269. PMID 11208236
^ H. Schubothe: Internal diseases caused by physical environmental factors. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid. 1961, pp. 1161–1194, here: p. 1161 ( Die Contusio cordis ).

[1] LA Geddes, RA Roeder: Evolution of our knowledge of sudden death due to commotio cordis. In: Am J Emerg Med. (2005); 23, pp. 67-75. PMID 15672341 .

[2] MS Link et al .: What is commotio cordis? In: Cardiol Rev. (1999); 7, pp. 265-269. PMID 11208236

[3] H. Schubothe: Internal diseases caused by physical environmental factors. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid. 1961, pp. 1161–1194, here: p. 1161 ( Die Contusio cordis ).