Perforation of the right cardiac ventricle as a late complication of a displaced sternal fracture following blunt trauma

Am J Emerg Med. 2022 May;55:229.e1-229.e3. doi: 10.1016/j.ajem.2022.01.031. Epub 2022 Jan 21.

Abstract

Cardiac tamponade is a rare but possibly fatal complication of blunt thoracic trauma complicated by a sternal fracture. A delayed presentation of cardiac tamponade days or weeks after initial trauma has been described in a few cases. In these cases, the presumed mechanism of cardiac tamponade is pericardial irritation, caused by osseous fragments of the fractured sternum. This case describes a direct mechanical perforation of the right ventricle, caused by a displaced sternal fracture, presenting 5 days after initial trauma. To our knowledge, this mechanism of late cardiac tamponade has not been described in recent literature.

Keywords: Cardiac tamponade; Sternal fracture; Thoracic trauma; Trauma.

Publication types

  • Case Reports

MeSH terms

  • Cardiac Tamponade* / complications
  • Cardiac Tamponade* / etiology
  • Fractures, Bone* / complications
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / injuries
  • Humans
  • Sternum / diagnostic imaging
  • Sternum / injuries
  • Thoracic Injuries* / complications
  • Wounds, Nonpenetrating* / complications