A Report of Three Patients Surviving Near- Fatal Blunt Cardiac Rupture
Keywords:
Blunt cardiac rupture, Cardiac tamponadeAbstract
Blunt cardiac rupture is a rare condition that has a high mortality rate without prompt treatment. This paper reports three patients who survived blunt cardiac rupture, and a literature review was conducted as a reference for further management of this condition. The first patient was a man who sustained a motor-vehicle accident. Upon arrival, he appeared hypotensive and was found to have bilateral pleural effusion and cardiac tamponade with elevated cardiac enzymes. Bilateral chest tubes were inserted. He was brought to the operating room and went into cardiac arrest. Resuscitative thoracotomy was performed, as well as a definitive repair of the cardiac injury. The patient recovered and was discharged. The second patient was a woman, also in a motor-vehicle accident. She appeared hypotensive at the emergency department, where fractured ribs, a pneumothorax, and cardiac tamponade were detected. Chest tube insertion was performed and the patient taken to the operating room where definitive repair was done. She developed a clotted hemothorax for which a thoracotomy was performed to remove the blood clot. She recovered well and was discharged from the hospital. The last patient was a man who fell 7 meters. He had hypotension upon arrival as well as cardiac tamponade. He was brought to the operating room for definitive repair and recovered well and was subsequently discharged. All patients had multiple associated injuries. In conclusion, blunt cardiac rupture is a rare condition and difficult to diagnose. The mortality rate is high, but with prompt management, patients who survived to the hospital may have good outcomes. Prehospital management is also crucial.
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