Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

Abstract

Background: Isolated right atrial rupture is a very rare catastrophic complication of cardiopulmonary resuscitation. Objective: We described a rare case of right atrial rupture after external cardiac massage. Methods: We reported the case of a 62-year-old male patient who developed excessive bleeding following external cardiac massage for sudden cardiac arrest in the intensive care unit after coronary artery bypass grafting. Results: This man underwent successful emergency repair of the tear of the right atrium without using cardiopulmonary bypass. Conclusion: Right atrial rupture can occur after external cardiac massage. An emergency repair is needed.

Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report

“…Theoretically, when faced with a case of blunt chest trauma associated with cardiac tamponade, and unstable hemodynamic status, one must immediately think of an intrathoracic surgical lesion (such as heart, great vessels) [1,6,7]. Cardiac rupture presents sometimes with massive hemothorax (in case of traumatic pericardiac laceration, postoperative pericardiotomy or traumatic associated rib fractures), and in this situation, it is difficult for the chest surgeon to estimate the origin of bleeding that suspects cardiac rupture, and as a result delayed diagnosis leads to poor prognosis [8,[14][15][16]. Even in the absence of overt clinical signs of cardiac tamponade, pericardial free fluid coupled with the appropriate mechanism of injury raises suspicion for tamponade and/or chamber rupture [17,5,7,8].…”

“…The right atrium is a thin-walled structure that is susceptible to injury from blunt chest trauma, particularly in cases of high-impact trauma. Autopsy studies have proved that the right atrial appendage is thinner than the right atrial wall and hence theoretically is more susceptible to rupture [5,15]. Moreover, the initial symptoms may be non-specific and can mimic other conditions and there is no universally accepted diagnostic criteria for the assessment of atrial rupture as there have been many documented presentations for such an injury in the literature [18].…”

Positive Murphy’s Sign in Pericardial Hematoma from a Right Atrial Tear

“…Coming to cardiac chamber injuries, these can be secondary to blunt trauma [ 10 - 12 ] with cardiopulmonary resuscitation [ 13 ] with chest trauma being the most common cause for chamber injury based on our literature search. Delgado et al reported an atrial tamponade causing an acute ischemic hepatic injury in the immediate postop period after cardiac surgery [ 14 ].…”