Traumatic Myocarditis

OVERVIEW
Traumatic myocarditis is the term applied to the syndrome of arrhythmias that sometimes complicates blunt trauma; it is a misnomer, because myocardial lesions (if present) are more likely to take the form of necrosis than inflammation.
Direct cardiac injury is not required for development of posttraumatic arrhythmia; extracardiac conditions are likely to have equal or greater etiologic importance.
Ventricular tachyarrhythmias occur in most affected patients; supraventricular arrhythmias and bradyarrhythmias are uncommon. Ventricular rhythms that complicate blunt trauma are often relatively slow and detected only during pauses in the sinus rhythm; they are most appropriately referred to as AIVRs. The QRS complexes are wide and bizarre; the rate is > 100 bpm but generally < 160 bpm. Usually, these rhythms are electrically and hemodynamically benign.
Dangerous ventricular tachycardias can also complicate blunt trauma and can also evolve from seemingly benign AIVRs, compromising perfusion and placing the patient at risk for sudden death.