Blunt Traumatic Rupture of the Heart and Pericardium:

Fulda, Gerard J.; BRATHWAITE, C. M. E.; Rodríguez, Aurelio; Turney, Stephen Z.; Dunham, C. Michael; Cowley, R. Adams

doi:10.1097/00005373-199131020-00003

Cited by 211 publications

(70 citation statements)

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“…In contrast, a traumatic ventricular tear tends to be rapidly fatal and fewer patients survive. In Fulda's series 2) of eighteen cases with ventricular tear, none survived. In the series of Martin 3) of 6 cases with ventricular tear, 3 survived.…”

Section: Discussionmentioning

confidence: 95%

“…In contrast, blunt traumatic atrial tear tends to have a better prognosis than ventricular tear. 2,3) However, the clinical manifestations of blunt traumatic cardiac chamber rupture are usually subtle, and unless the physician has a high index of suspicion, the diagnosis can be missed, resulting in delayed treatment and increased mortality. Herein, we present three cases with blunt traumatic right atrial tear that were successfully treated with cardiorrhaphy.…”

mentioning

confidence: 99%

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Isolated Right Atrial Tear Following Blunt Chest Trauma.

Fang¹,

Kuo²,

Li³

et al. 2000

Jpn Heart J

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SUMMARYBlunt chest trauma causing isolated right atrial tear and cardiac tamponade in three patients is reported. All three patients presented with hypotension, elevated central venous pressure and altered consciousness. Echocardiographic examination demonstrated pericardial effusion in all three cases. All three patients underwent operation with a median sternotomy approach without using cardiopulmonary bypass. At operation, two patients had one tear in the right atrium, the other had two tears in the right atrium. All three patients recovered uneventfully. Early use of echocardiography to detect the presence of hemopericardium and cardiac tamponade in patients with suspected atrial rupture following blunt chest trauma is advocated. (Jpn Heart J 2000; 41: 535-540) Key words: Blunt cardiac injury, Atrial tear, Cardiac tamponade BLUNT chest trauma causing cardiac chamber rupture is rare and carries a high mortality rate. It is estimated that cardiac chamber rupture occurs in 10 to 15% of victims of fatal vehicular accidents. 1) Blunt traumatic ventricular rupture tends to be rapidly fatal and few patients survive. In contrast, blunt traumatic atrial tear tends to have a better prognosis than ventricular tear.2,3) However, the clinical manifestations of blunt traumatic cardiac chamber rupture are usually subtle, and unless the physician has a high index of suspicion, the diagnosis can be missed, resulting in delayed treatment and increased mortality. Herein, we present three cases with blunt traumatic right atrial tear that were successfully treated with cardiorrhaphy.

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Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

Isolated Right Atrial Tear Following Blunt Chest Trauma.

Fang¹,

Kuo²,

Li³

et al. 2000

Jpn Heart J

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“…Most patients never reach the hospital, and those who do often have severe associated injuries [2]. A pericardial rupture should be suspected in a patient with severe blunt trauma to the chest [7]. However to our knowledge there are no prior reports of spontaneous non-traumatic pericardial rupture into the pleura and lung parenchyma [8].…”

Section: Discussionmentioning

confidence: 99%

A Curious Case of Pericardiohydroptysis

Mohammad

2013

J Med Cases

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Rupture of the heart or pericardium is a rare clinical finding almost always associated with trauma to the chest. Non-traumatic pericardial rupture into the lung parenchyma and pleural space has not been reported in literature. Hence the progression or natural course is not known and the optimal management not defined. We report a case of a 65-year-old male patient with past medical history of hypertension and alcohol abuse who presented with complaints of fever, and sharp retrosternal chest pain and was found to have rupture of the pericardium into the right pleural space and lung parenchyma. The diagnosis was established with a computed tomography scan of the chest and a cardiac magnetic resonance imaging. Routine investigation and a surgical biopsy of the pericardium could not establish a cause for the pericardial rupture. He was treated as idiopathic pericarditis with improvement over time, and a repeat echocardiogram showed resolution of the pericardial effusion. More than a year after the initial presentation, the patient is stable with no complications. From the sequence of events, we presume that the productive cough which immediately preceded this diagnosis represented the coughing up of pericardial fluid (pericardiohydroptysis).

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“…• Blast injury [7,16,27,28]. BTIs can also lead to penetrating cardiac injuries in the form of broken rib or sternum can lacerate the heart [8,25] .…”

Section: Pathophysiologymentioning

confidence: 99%