Contusio Cordis Associated with Atrioventricular Block and Tricuspid Regurgitation

The expression “contusio cordis” defines a lesion of the cardiac myocyte, hemorrhagic or fibrotic, due to the application of violent kinetic force resulting from a blunt trauma to the precordial region1. Syncope is almost always the first clinical manifestation observed, and commonly precedes death. Contusio cordis differs from commotio cordis, the latter representing a cardiac electromechanical disorder consequent to a blunt trauma to the precordial region, at a critical moment of the cardiac cycle, which occurs within 10 to 30 ms from the T-wave peak, a period susceptible to the development of ventricular fibrillation2-5. Both forms are fatal most of the time2,3,6-9. Commotio cordis is a form of ventricular fibrillation, rather than a lesion in cardiomyocytes or adjacent organs2,3. It is a rare condition, leading most cases to death6, and being more prevalent among men, because of its relationship to high-impact sports3,6. The accurate incidence of both entities is unknown, because there is no systematic way to register all cases; however, although rare in the literature, they are believed to be more common than reported3,6. Contusio cordis associated with complete atrioventricular block (CAVB) is an even rarer condition, with few cases reported7. The objective of the present study is to report a case of contusio cordis associated with CAVB and tricuspid regurgitation (TR).