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Delayed heart perforation after blunt trauma.

Thierry Roth¹, Beat Kipfer, Jukka Takala

¹Division of General Thoracic Surgery, University Hospital, 3010 Berne, Switzerland.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|January 15, 2002

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A patient with blunt chest trauma and flail chest developed sudden hypotension and tachycardia due to cardiac tamponade. Emergency surgery successfully treated the left ventricular perforation, leading to a favorable outcome.

Area of Science:

Cardiothoracic Surgery
Trauma Surgery
Emergency Medicine

Background:

Blunt chest trauma can lead to severe thoracic injuries.
Flail chest is a critical condition requiring intensive care.
Complications such as cardiac tamponade can arise rapidly after trauma.

Observation:

A 33-year-old male presented with left flail chest post-blunt trauma.
Six hours post-ICU admission, he developed hypotension and tachycardia.
Massive hemothorax (1.5 L) was noted from the chest tube.

Findings:

The patient experienced pericardial tamponade caused by left ventricular perforation.
A sharp rib fragment was identified as the cause of perforation.
Emergency sternotomy with pericardial decompression was performed.

Related Experiment Videos

Implications:

Prompt diagnosis and surgical intervention are crucial for survival in traumatic cardiac tamponade.
Internal fixation of flail chest can be safely performed after initial stabilization.
This case highlights the importance of vigilant monitoring in trauma patients.