Late cardiac tamponade after cardiac trauma: A case report and a review

Abstract

The pericarditis is an inflammation process of the pericardium with lots of causes, primary and secondary. It may progress with pericardial effusion and/or constrictive pericarditis. The presentation as late cardiac tamponade due to trauma is a rare clinical condition and may occur days or weeks after trauma. We report a case observed in a trauma hospital of Manaus-Amazonas, Brazil periphery. The patient presented to the hospital 18 days after a chest trauma with signs and symptoms of cardiac tamponade: tachycardia, turgid jugular veins, inferior limbs swollen, presenting breathing difficulties, and supine position not tolerated. He underwent exploratory thoracotomy, and a thick pericardium with purulent effusion was found. It is important to suspect cadiac injury in patients who are victims of trauma on cardiac box, to observe that the focused assessment sonography for trauma is used, but it has its limitations. It is 90%–95% accurate for the presence of pericardial fluid for the experienced operator. Concomitant hemothorax may account for both false-positive and false-negative ultrasound examinations.[2] When necessary, the subxiphoid exploration must be done. The possibility of occult cardiac lesion or silent cardiac wound should always be considered in patients with chest trauma by knife or gunshot on Zieddler area or cardiac box, to prevent a late cardiac tamponade or pericarditis.