Abstract
BackgroundTraumatic hemopericardium remains a rare entity; it does however commonly cause cardiac tamponade which remains a major cause of death in traumatic blunt cardiac injury.ObjectivesWe present a case of blunt chest trauma complicated by cardiac tamponade causing cardiac chamber equalization revealed by reflux of contrast.Case reportA 29-year-old unidentified male suffered blunt chest trauma in a motor vehicle collision. Computed tomography (CT) demonstrated a periaortic hematoma and hemopericardium. Significant contrast reflux was seen in the inferior vena cava and hepatic veins suggesting a change in cardiac chamber pressures. After intensive treatment including cardiac massage this patient expired of cardiac arrest.ConclusionReflux of contrast on CT imaging can be an indicator of traumatic cardiac tamponade.
Highlights
Traumatic hemopericardium remains a rare entity; it does commonly cause cardiac tamponade which remains a major cause of death in traumatic blunt cardiac injury
We present a case of blunt chest trauma including cardiac tamponade revealed by contrast reflux at Computed tomography (CT)
Remarkable contrast reflux was seen into the inferior vena cava (IVC) and hepatic veins
Summary
Traumatic hemopericardium remains a rare entity; it does commonly cause cardiac tamponade which remains a major cause of death in traumatic blunt cardiac injury. Objectives: We present a case of blunt chest trauma complicated by cardiac tamponade causing cardiac chamber equalization revealed by reflux of contrast. We present a case of blunt chest trauma including cardiac tamponade revealed by contrast reflux at CT. Remarkable contrast reflux was seen into the inferior vena cava (IVC) and hepatic veins This phenomenon was presumably caused by equalization of cardiac chamber pressures typical of tamponade. Even though emergent thoracotomy following blunt trauma carries an overall survival rate of only 1-2% [2], after the loss of vital signs, emergent thoracotomy was performed and 2.5 liters of pericardial blood was found originating from a right atrial tear This case shows that the use of contrast in CT can reveal changes in cardiac chamber pressures possibly indicating traumatic cardiac tamponade
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