Blunt Trauma Rupture of the Heart

Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness

“…Although not supported by clinical or experimental data, diverse mechanisms were proposed for heart rupture in BT, including: sudden deceleration [12], the occurrence of rib fractures [5,11,14,22,23] increased intracardiac hydraulic pressure resulting from abdominal/lower limb venous compression [12], mechanical heart compression [8,12,13], the phase of the cardiac cycle [9,24], concommitant interaction of these factors [9]. In the analysis of the here discussed 9 cases, none of the above mentioned factors could be identified as the main determinant of the RAA rupture.…”

“…Given the anatomicotopographic relationship between the RAA and the RA, their walls are under the same hydraulic pressure. According to Trueblood [13], the thinner wall of the RAA could render this chamber more prone to rupture under heart compression between the sternum and thoracic spine. The results of our anatomic study show that RAA wall is thinner than RA wall.…”

“…Eleven other RAA cases mentioned in the literature without clear informative data are not included here [8,13]. …”

“…Among the diverse mechanisms proposed for traumatic rupture of heart chambers [8,9,12,13], the thickness of the chamber wall has been presumed to be a possible factor [12,13], and the atrium appendage has been supposed to be the thinnest and weakest portion of the heart [13]. However, no research has been mentioned supporting this hypothesis.…”

Ruptura cardíaca por trauma contuso de tórax. Un caso inusual

“…[10][11][12] La supervivencia de la rotura cardíaca secundaria a TTC es muy inferior a la secundaria a lesión penetrante. Así, en la serie de Baillot et al [11][12][13] que incluía roturas cardíacas o de aorta, la mortalidad para los que llegaron vivos al hospital fue de 8.5% en las heridas penetrantes y del 43% en las secundarias a TTC. Si tenemos en cuenta que en ellas se incluían lesiones de aorta y lesiones valvulares, podemos inferir que la mortalidad por rotura cardíaca es notablemente superior.…”