Extrapericardial cardiac tamponade due to massive retrosternal hematoma

Extrapericardial cardiac tamponade secondary to traumatic hemorrhage of the thymus

“…Rodgers-Fischl et al describe a 10 × 7 × 6 cm mediastinal hematoma causing tamponade after BCT, and Sabatel-Perez et al describe an 11 × 9 cm mediastinal hematoma that caused tamponade 4 days after cardiothoracic surgery. 2,3 In our patient, significant hemodynamic compromise began to occur shortly after CT revealed a 9 × 5.6 cm retrosternal hematoma. It appears that a large volume of fluid is better tolerated with acute extrapericardial tamponade than with acute intrapericardial tamponade because the mediastinum is a larger compartment than the parietal pericardium.…”

“…Several case reports have described extrapericardial cardiac tamponade; the most common etiologies appear to be post-surgical and traumatic hemorrhage. 3 Few case reports describe blunt chest trauma causing an anterior mediastinal hematoma leading to tamponade physiology. 2,4,5 In our patient, initial differential diagnoses included hemorrhagic shock, blunt cardiac injury, and cardiac tamponade.…”

Cardiac tamponade as a cause of COVID-19

“…It consists in filling the pericardial cavity with a fluid that has the nature of an exudate or effusion, thus hindering filling the atria. Tamponade may arise because of infarction, trauma, mediastinal tumors and many other clinical conditions [2,3].…”