Abstract: The mechanical trauma ranks third in the structure of death rate in peaceful time, and it is a leading cause of death in the age group before 40 years old. The closed blunt injury constitutes up to 50,4 per cent of all of the mechanical injuries, and usually the traumatized organs are lungs and heart. The heart contusion is one of the most typical traumas of this organ, and it has  critical clinical progression due to the fulminant development after the hit influence  of acute myocardial dysfunction, which is caused mostly by the traumatic acute violations of coronary blood circulation and microcirculatory disorder. It is accompanied by the depression of myocardial contractility and lowering of its functional reserve due to the acute change of metabolic elements right after the trauma.  As a result of these processes the hypoxic mechanism of myocardial trauma develops regularly. If the heart contusion is severe, it is usually fatal for a person. A number of works on heart contusion were provided by clinical doctors, so the problem of morphological diagnosis of this type of trauma remains topical for many years. Clarification of mechanisms of development of the acute myocardial insufficiency in cases of heart contusion is important first of all for the specialists working with the problem of heart contusion – emergency doctors and medicolegists.