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Obstructive shock from delayed blunt cardiac injury after chest trauma
Olivia Sosnoski1,2,3, Jeffery Cloyd4, Blake Briggs4
1The University of Tennessee Health Science Center Knoxville, Knoxville, TN, USA. olivia.sosnoski@advocatehealth.org.
International Journal of Emergency Medicine
|August 14, 2026
Summary
Delayed blunt cardiac injury (BCI) can present as pericarditis one week after a motor vehicle accident (MVA). Point-of-care ultrasound (POCUS) aided diagnosis in a patient with limited history, emphasizing BCI awareness.
Area of Science:
- Emergency Medicine
- Cardiology
- Trauma Surgery
Background:
- Blunt cardiac injury (BCI) is a rare but serious emergency department presentation.
- BCI can be complicated by other injuries, leading to delayed recognition.
- Potential complications include pericarditis and cardiac tamponade; no current guidelines exist for BCI evaluation.
Purpose of the Study:
- To report a unique case of delayed BCI presenting as pericarditis one week post-MVA.
- To highlight the diagnostic utility of point-of-care ultrasound (POCUS) in challenging BCI cases.
- To underscore the need for increased awareness and structured diagnostic approaches for BCI.
Main Methods:
- Case report of a patient presenting one week after an MVA with delayed BCI.
- Literature review to identify similar cases of delayed BCI.
- Utilized physical examination, imaging, and laboratory findings, with POCUS being pivotal.
Main Results:
- The patient presented with delayed pericarditis one week after the MVA.
- A literature search revealed only one similar previously reported case.
- POCUS was crucial for initial evaluation, especially given the patient's inability to provide a detailed history.
Conclusions:
- BCI diagnosis is challenging due to variable and delayed presentations.
- A high index of suspicion is crucial for BCI, especially in patients with chest trauma and delayed care.
- Early intervention and a multimodal diagnostic approach (physical exam, imaging, labs) are vital for preventing severe outcomes.
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