Published: 2019-09-26

A case report of cardiac tamponade following blunt chest trauma

Vidhi Mehta, Pallavi Shambhu, S. Prabhakar


Traumatic cardiac tamponade due to blunt chest injury is a life threatening and time-critical emergency that requires early recognition and prompt management often alongside other resuscitative considerations. We present here a case of 25 year old male with history of blunt chest trauma with hypotension and raised central pressures. The patient was taken up for exploratory laparotomy which proved negative and the central tendon bulge of diaphragm was seen. Hence, the decision was made to examine the pericardial space via thoracotomy to find cardiac tamponade of 400 cc. Immediate intra- operative stabilization of vitals was seen on relieving the intra pericardial pressures. Any patient with severe blunt chest trauma, disproportionate hypotension that is not responding to fluid resuscitation along with elevated central venous pressures should be thoroughly evaluated for cardiac tamponade.


Cardiac tamponade, Blunt chest trauma, Echocardiography

Full Text:



Gorman R, Nuttall SM. Traumatic right ventricular rupture following a horse kick. BMJ Case Reports 2012;2012:bcr2012006657.

Nauta FJ, Borstlap WA, Stella M, Khalpey Z. Cardiac tamponade: contrast reflux as an indicator of cardiac chamber equalization. J Cardiothorac Surg. 2012;7:48.

Teixeira PG, Inaba K, Oncel D, DuBose J, Chan L, Rhee P et al Blunt cardiac rupture: a 5-year NTDB analysis. J Trauma. 2009;67(4):788-91.

Dalvi AN, Gondhalekar RA, Shirhatti RG, Joshi SV, Sukthankar RU, Mathur SK. Atrial rupture following blunt chest trauma (a case report). J Postgrad Med. 1987;33:152.

Demetriades D, van der Veen BW. Penetrating injuries of the heart: experience over 2 years in South Africa. J Trauma. 1983;23:1034-41.

Trueblood HW, Wuerflein RD, Angell WW. Blunt trauma rupture of the heart. Ann Surg. 1973;177(1):66-9.

Parmley LF, Manion WC, Mattingly TW. Non penetrating injury of the heart. Circulation. 1958;18:371-96.

Bright EF, Beck CS. Nonpenetrating wounds of the heart. A clinical and experimental study. Am Heart J. 1935;10:293-32.

Getz BS, Davies E, Steinberg SM, Beaver BL, Koenig FA. Blunt Cardiac Trauma Resulting in Right Atrial Rupture. JAMA. 1986;255(6):761-3.

PĂ©rez-Casares A, Cesar S, Brunet-Garcia L, Sanchez-de-Toledo J. Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade. Frontiers Pediatr. 2017;5:79.

Singh S, Wann LS, Klopfenstein HS, Hartz A, Brooks HL. Usefulness of right ventricular diastolic collapse in diagnosing cardiac tamponade and comparison to pulsus paradoxus. Am J Cardiol. 1986;57:652-6.

Bull RK, Edwards PD, Dixon AK. CT dimensions of the normal pericardium. Br J Radiol. 1998;71:923-5.

Himelman RB, Kircher B, Rockey DC, Schiller NB. Inferior vena cava plethora with blunted respiratory response: a sensitive echocardiographic sign of cardiac tamponade. J Am Coll Cardiol. 1988;12(6):1470-7.

Yun JH, Byun JH, Kim SH, et al. Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years. Korean J Thorac Cardiovasc Surg. 2016;49(6):435-42.

Swaanenburg JC, Klaase JM, DeJongste MJ, Zimmerman KW, ten Duis HJ, Troponin I. CKMB-activity and CKMB-mass as markers for the detection of myocardial contusion in patients who experienced blunt trauma. Clin Chim Acta. 1998;272:171-81.