Blunt traumatic rupture of the heart. Successful repair of simultaneous rupture of the right atrium and left ventricle

Abstract

A case is reported of a 48-year-old man who sustained simultaneous rupture of the right atrium and left ventricle following blunt trauma in a motor vehicle accident. Rupture of one or more cardiac chambers in blunt cardiac trauma is not uncommon. However, survival to reach the hospital is rare. The clinical features of cardiac rupture are those of pericardial tamponade or hemorrhage, depending on whether or not the pericardium is intact. Successful management of cardiac rupture in the few reported survivors has depended on a high index of suspicion when signs of tamponade occur after blunt injury. Prompt exploration is essential, as few patients survive longer than 60 minutes after injury. Ready availability of cardiopulmonary bypass is emphasized. Atrial rupture can be managed without bypass, but left ventricular rupture, as in this case, would seem impossible to repair without it.