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Blunt cardiac rupture: the utility of emergency department ultrasound

N P Symbas1, P F Bongiorno, P N Symbas

  • 1Department of Surgery, Grady Hospital, Emory University School of Medicine, Atlanta, Georgia 30303, USA.

The Annals of Thoracic Surgery
|June 4, 1999
PubMed

Insights

Cardiac rupture from blunt trauma is often fatal, but prompt diagnosis and surgical repair can improve survival. This case series highlights successful outcomes with immediate ultrasound and primary repair, even without cardiopulmonary bypass.

Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Cardiology

Background:

  • Cardiac rupture is a severe, often fatal, consequence of blunt trauma.
  • Prompt diagnosis and treatment are critical for survival in patients who reach the emergency department alive.

Observation:

  • Four consecutive patients with free cardiac wall rupture due to motor vehicle accidents were treated.
  • Diagnoses were established via ultrasound (3 patients) or exploratory surgery (1 patient).
  • All cardiac tears were repaired surgically without cardiopulmonary bypass.

Findings:

  • Three out of the four patients survived the cardiac rupture repair.
  • The study involved tears of the right ventricle, right atrium, and left atrium.

Implications:

  • Increased prehospital care and transport may lead to more patients presenting with cardiac rupture.
  • Physicians must maintain a high index of suspicion for cardiac rupture in blunt trauma.
  • Immediate ultrasonography and prompt surgical intervention are key to improving survival rates for cardiac rupture.
Abstract

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