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Blunt Cardiac Rupture: A Diagnostic Challenge

Suraj Pinni1, Vineet Kumar2, Satish Balkrishna Dharap3

  • 1Post Graduate Resident, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .

Journal of Clinical and Diagnostic Research : JCDR
|January 5, 2017
PubMed

Insights

Blunt cardiac rupture (BCR) is a critical injury. Prompt diagnosis and treatment, even without advanced imaging, can save patients with complex trauma.

Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Cardiology

Background:

  • Blunt cardiac rupture (BCR) is a severe, often fatal, thoracic injury.
  • Patients with BCR frequently present in shock, posing diagnostic and therapeutic challenges.

Observation:

  • A patient with multiple blunt force injuries presented with shock and mediastinal widening.
  • Cardiac tamponade was suspected clinically and radiographically.

Findings:

  • Diagnosis was confirmed via subxiphoid pericardial window in the absence of echocardiography.
  • Emergency thoracotomy revealed a right atrial appendage rupture, surgically repaired.
  • The patient also had a grade IV splenic injury requiring splenectomy and other injuries managed conservatively.

Implications:

  • This case highlights the importance of adhering to trauma resuscitation protocols.
  • Timely intervention, even with limited diagnostic tools, can be life-saving for complex blunt trauma.
  • Effective management of BCR and associated injuries is achievable with prompt surgical correction.

Keywords:
Cardiac tamponadeFocussed assessment with sonography in traumaPolytraumaRight atrial appendage

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