Blunt cardiac injury (BCI) can lead to a variety of heart lesions depending on the severity and site of trauma. The presence of certain risk factors can help identify a patient who should be closely monitored for these complications.


Risk factors for blunt heart injury:

(1) age > 50 years

(2) history of existing cardiac disease


(3) vehicular accident with chest impact at speed > 15 miles per hour

(4) deformation of steering wheel


(5) marked precordial tenderness, ecchymosis or contusion

(6) fractured sternum


(7) multiple injuries

(8) fractures of thoracic spine or ribs


(9) hemodynamically unstable


As the number of risk factors increase, so does the risk of blunt injury to the heart.


If only a single risk factor is present, items 3 to 6 would seem to infer a greater risk than factors like age or a previous history of cardiac disease.


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