Delayed pericardial effusions: life-threatening complication presenting up to 100 days after chest trauma

Nijjer, Sukhjinder; Dubrey, Simon W; Dreyfus, Gilles; Grocott-Mason, Richard

doi:10.7861/clinmedicine.10-1-88

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…A diagnostic and therapeutic challenge: delayed cardiac tamponade can occur up to 100 days after the index injury, and it may have an atypical presentation [ 5 ]. The etiology of the late presentation is unclear, although several mechanisms have been proposed including clot sealing a partial tear that either allows a slow leak into the pericardial sac or suddenly dislodges leading to more rapid accumulation [ 3 ]; autoimmune pericarditis and subsequent pericardial effusion; and unidentified laceration of a coronary artery with subsequent spasm that later hemorrhages [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Almehmadi

Chandy

Connelly

et al. 2016

Case Reports in Cardiology

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Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse. The pericardial effusion was treated with emergent pericardiocentesis and later required a thoracoscopy guided pericardial window for definitive management.

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Section: Discussionmentioning

confidence: 99%

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Almehmadi

Chandy

Connelly

et al. 2016

Case Reports in Cardiology

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“…2 In many other reported cases, sternotomy or thoracotomy has been performed for definitive management. [6][7][8][9][10][11] In the case of our patient, management included placement of a pericardial drain, which was removed 2 days after insertion. The recurrent effusion that subsequently developed was also treated with percutaneous drainage.…”

Section: Discussionmentioning

confidence: 99%

Delayed pericardial effusion and cardiac tamponade following penetrating chest trauma

Donahoe

Ouzounian

MacDonald

et al. 2013

CJEM

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We present the case of a 20-year-old man who was stabbed in the left chest and was diagnosed with a large pericardial effusion by focused emergency department (ED) ultrasonography. After placement of a left chest tube for presumed tension pneumothorax, the pericardial effusion had resolved. The patient's postinjury course was complicated by pericarditis and recurrent tamponade, which required repeated pericardiocentesis for management. This case illustrates the role of focused ED ultrasonography for diagnosis of pericardial effusion in penetrating trauma and the potential for delayed pericardial effusion and tamponade in such patients. Although the pathophysiology of delayed pericardial effusion is unclear, autoimmune postpericardiotomy syndrome has been proposed as the cause of this rare condition. Our case underscores the importance of close monitoring of patients with known or suspected pericardial injuries due to their potential for the development of lifethreatening complications. RÉ SUMÉNous faisons é tat, dans le pré sent article, du cas d'un homme de 20 ans qui a reç u des coups de couteau dans le thorax gauche; une é chographie focalisé e, effectué e au service des urgences (SU) a permis de diagnostiquer un important é panchement pé ricardique. Aprè s la pose d'un drain thoracique à gauche pour traiter un pneumothorax à soupape pré sumé , l'é panchement pé ricardique s'est ré sorbé . Toutefois, la convalescence s'est compliqué e d'une pé ricardite et de tamponnades ré cidivantes, qui ont né cessité des ponctions pé ricardiques à ré pé tition. L'exposé de cas met en é vidence le rô le de l'é chographie au SU dans le diagnostic d'un é panchement pé ricardique consé cutif à une blessure pé né trante et le risque d'apparition tardive d'un é panchement pé ricardique et de tamponnade en pareilles circonstances. L'on ne connaît trè s bien le processus physiopathologique de l'é panchement pé ricardique, mais certains ont avancé le syndrome de postpé ricardiotomie auto-immune comme cause possible de cette affection rare. La description du cas fait ressortir l'importance de la surveillance é troite des patients chez qui il y a une pré sence pré sumé e ou avé ré e de lé sions pé ricardiques, en raison du risque d'apparition de complications potentiellement mortelles.

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Sudden death associated with delayed cardiac rupture: case report and literature review

Tinzin,

Gao,

et al. 2024

Front. Cardiovasc. Med.

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Cardiac injury plays a critical role in the process of thoracic trauma-related fatal outcomes. Historically, most patients who suffer a cardiac rupture typically die at the scene of occurrence or in the hospital, despite prompt medical intervention. Delayed cardiac rupture, although rare, may occur days after the initial injury and cause sudden unexpected death. Herein, we present the clinical details of a young man who suffered a chest stab injury and recovered well initially, but died days later due to delayed cardiac rupture. The forensic autopsy confirmed delayed cardiac rupture as the cause of death. We also reviewed previous similar reports to provide suggestions in such rare cases in clinical and forensic practice.

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Delayed pericardial effusions: life-threatening complication presenting up to 100 days after chest trauma

Cited by 3 publications

References 9 publications

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

Delayed pericardial effusion and cardiac tamponade following penetrating chest trauma

Sudden death associated with delayed cardiac rupture: case report and literature review

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