[Right atrium rupture due to blunt trauma].

Area of Science:

• Cardiology
• Trauma Surgery
• Emergency Medicine

Background:

• Blunt cardiac trauma presents a significant clinical challenge, often leading to life-threatening conditions such as cardiac rupture and cardiac tamponade.
• Prompt and accurate diagnosis is essential for effective management of blunt cardiac trauma.

Observation:

• Two cases of blunt cardiac trauma are presented: one with cardiac rupture and another with cardiac tamponade progressing to hemorrhage.
• Case 1 involved a patient with cardiac rupture due to severe chest impact, treated with emergency thoracotomy.
• Case 2 involved a patient with cardiac tamponade, initially managed with pericardial drainage, followed by thoracotomy for a cardiac laceration.

Findings:

• Emergency thoracotomy was successfully employed in both cases, with one requiring direct repair of a right atrial injury near the inferior vena cava (IVC).
• The first patient's cardiac rupture required thoracotomy, but bleeding ceased spontaneously. The second patient's cardiac tamponade necessitated drainage and subsequent thoracotomy for suture repair of a right atrial laceration.
• Both patients experienced uneventful postoperative courses following surgical intervention for their blunt cardiac trauma.

Implications:

• Pericardial drainage in cardiac rupture cases should be performed with readiness for thoracotomy.
• These cases highlight the critical role of surgical intervention in managing severe blunt cardiac trauma, emphasizing the need for preparedness in emergency settings.
• Effective management of blunt cardiac trauma, including cardiac rupture and tamponade, relies on timely diagnosis and surgical expertise.