Hemopericardium and Cardiac Tamponade After Blunt Thoracic Trauma: A Case Series and the Essential Role of Cardiac Ultrasound

J Emerg Med. 2021 Sep;61(3):e40-e45. doi: 10.1016/j.jemermed.2021.05.013. Epub 2021 Jun 30.

Abstract

Background: Severe cardiac injury caused by penetrating rib or sternal fractures after blunt chest trauma is a rare clinical entity that has been described in only a few case reports over the last half-century. As a result, questions have arisen about the utility of the cardiac component in the Focused Assessment with Sonography in Trauma (cFAST) examination in evaluating blunt trauma patients.

Case report: We present a series of 3 patients who sustained blunt trauma and were discovered on cFAST examination to have developed pericardial tamponade from overlying rib or sternal fractures in the emergency departments of two academic level I trauma hospitals in the United States. Why Should an Emergency Physician Be Aware of This? These cases highlight the need for emergency and trauma physicians to be aware of blunt-induced, penetrating trauma to the heart and mediastinum, and for future trauma care guidelines to consider the importance of the cFAST examination.

Keywords: Emergency medicine; Emergency ultrasound; Pericardial tamponade.

Publication types

  • Case Reports

MeSH terms

  • Cardiac Tamponade* / diagnostic imaging
  • Cardiac Tamponade* / etiology
  • Heart Injuries* / diagnosis
  • Heart Injuries* / diagnostic imaging
  • Humans
  • Pericardial Effusion* / diagnostic imaging
  • Pericardial Effusion* / etiology
  • Thoracic Injuries* / complications
  • Wounds, Nonpenetrating* / complications
  • Wounds, Nonpenetrating* / diagnostic imaging