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Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds. Localized bleeding from contusion could cause hemopericardium even without rupture.
In this pediatric study, it was 71% successful and better than amiodarone. Procainamide is another reasonable solution to the problem. It does not block the AV node but does slow phase 0 of depolarization, which will also frequently break the re-entrant cycle.
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