Hemopericardium from right atrial laceration in a newborn

Lu, Wen-Hsien; Chen, Yingyao; Pan, Jun-Yen; Wang, Hsiao-Ping; Chang, Jenn-Tzong; Hsieh, Kai‐Sheng

doi:10.1016/j.jcma.2011.08.009

Cited by 1 publication

(1 citation statement)

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“…This may be due to increased suspicion of a cardiac etiology when presented with cardiac tamponade, compared to potential delays in diagnosis and time to the operating room, associated with poorer outcomes, in patients that did not present with cardiac tamponade [46]. However, the clinical findings of “Beck’s triad” do not always present together, and up to 35% of cases do not present with cardiac tamponade (Table 1) [17]. Our patient developed profound hypotension but had weak carotid pulses with no jugular venous distension and auscultation of the heart was clear.…”

Section: Discussionmentioning

confidence: 99%

Isolated right atrial rupture from blunt trauma: a case report with systematic review of a lethal injury

Maraqa

Mohamed

Wilson

et al. 2019

J Cardiothorac Surg

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BackgroundIsolated right atrial rupture (IRAR) from blunt chest trauma is rare. There are no physical exam findings and non-invasive testing specific to the condition, which result in diagnostic delays and poor outcomes. We present a case of IRAR along with a systematic review of similar cases in the literature.Case reportA 23-year-old male presented following a motor vehicle accident (MVA). He was bradycardic and hypotensive during transportation; and required intubation. There were contusions along the right chest wall with clear breath sounds, and no jugular venous distension, muffled heart sounds. Hemodynamic status progressively worsened, ultimately leading to his death. However, no external sources of bleeding or evidence of cardiac tamponade was found.MethodsA search of PubMed, Ovid, and the Cochrane Library using: (Blunt OR Blunt trauma) AND (Laceration OR Rupture OR Tear) AND (Right Atrium OR Right Atrial). Articles were included if they were original articles describing cases of IRAR.ResultsForty-five reports comprising seventy-five (n = 75) cases of IRAR.ConclusionIRAR most commonly occurs following MVAs as the result of blunt chest trauma. Rupture occurs at four distinct sites and is most commonly at the right atrial appendage. IRAR is a diagnostic challenge and requires a high index of suspicion, as patients’ hemodynamics can rapidly deteriorate. The presentations vary depending on multiple factors including rupture size, pericardial integrity, and concomitant injuries. Cardiac tamponade may have a protective effect by prompting the search for a bleeding source. A pericardial window can be diagnostic and therapeutic in IRAR. Outcomes are favourable with timely recognition and prompt surgical intervention.

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Section: Discussionmentioning

confidence: 99%