The cardiac pendulum: blunt rupture of the pericardium with strangulation of the heart

J Trauma. 2005 Jul;59(1):136-41; discussion 141-2. doi: 10.1097/01.ta.0000171466.47885.c5.


Background: Blunt injury of the pericardium with strangulation of the heart is a rare clinical injury.

Methods: We conducted a review of clinical records and performed prospective collection of forensic data from a large urban medical examiner's office.

Results: Ten cases of blunt injury to the pericardium were identified. All were secondary to blunt trauma. Nine of the 10 cases had associated chest wall injuries and 5 of the 10 cases had cardiac strangulation.

Conclusion: Pericardial lacerations are common findings at autopsy. Clinically, those that survive to the hospital have a confusing presentation. They are often diagnosed during emergent thoracotomy for hemodynamic instability. Hemodynamic deterioration associated with change in patient position may be a clue to cardiac strangulation.

Publication types

  • Review

MeSH terms

  • Accidental Falls
  • Accidents, Traffic
  • Adult
  • Aged
  • Autopsy
  • Female
  • Heart Injuries / epidemiology*
  • Heart Rupture / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Pericardium / injuries*
  • Texas / epidemiology
  • Wounds, Nonpenetrating / epidemiology*