Right atrial free wall rupture after blunt chest trauma

Abstract

We report the case of an 18-year-old man, victim of a car accident, presenting with severe hypotension and signs of cardiac tamponade. Transoesophageal echocardiography was suggestive of right atrial free wall rupture. The patient underwent urgent cardiac surgery for repair of right atrial rupture. The immediate clinical outcome was favourable; the patient is in good general condition at 24-month follow-up. The right atrium is rarely involved in cardiac contusion as compared to the right ventricle or other cardiac structures, owing to its anatomical location and direction of physical forces.

Cardiac Trauma

“…9 Due to lower compliance, atrial rupture occurs less often, with right atrial rupture occurring more frequently than left atrial rupture due to its relative anterior location. 10 Cardiac tamponade due to atrial rupture occurs more slowly due to low pressures in the atria. Despite the anterior location of the tricuspid and pulmonary valves, the aortic and mitral valves are more affected secondary to trauma due to high mural pressures.…”

Cardiac tamponade due to right atrial rupture

“…They also used transfusion of crystalloids and blood to restore hemodynamic stability in the acute phase. [ 11 ] A case report by Feola et al . on isolated right atrial rupture due to blunt chest injury revealed that the patient's hemodynamics worsened after pericardiocentesis.…”

An isolated right auricular rupture following blunt chest trauma causing massive hemothorax

“…Bu tür yaralanmaların en sık nedeni, yüksek hızlı otomobil kazalarıdır. [6] Künt göğüs travmaları, basit bir kaburga kırığından, komplike trakeobronşiyal yaralanmalar ve kardiyovasküler rüptürlere kadar uzanabilen geniş bir yelpazeyi içerir. Künt kalp yaralanmaları penetran yaralanmalardan daha sık görülmesine rağmen, genellikle beraberinde çoklu organ yaralanması da olduğundan sıklıkla gözden kaçabilmektedir.…”

“…[3,5,6] Kalp yaralanmalarının ülkemizde hem penetran hem de künt travmalardan sonra %0.4-6 arasında görüldüğü bildirilmiştir. [2,3] Olgumuzda olduğu gibi oldukça nadir görülen künt göğüs travmasına bağlı, sağ aurikula yaralanması ise yüksek oranda mortalite ile ilişkili, katastrofik bir olaydır.…”