Hemopericardium and Cardiac Tamponade After Blunt Thoracic Trauma: A Case Series and the Essential Role of Cardiac Ultrasound.

BACKGROUND: Severe cardiac injury caused by penetrating rib or sternal fractures after blunt chest trauma is a rare clinical entity that has been described in only a few case reports over the last half-century. As a result, questions have arisen about the utility of the cardiac component in the Focused Assessment with Sonography in Trauma (cFAST) examination in evaluating blunt trauma patients.

CASE REPORT: We present a series of 3 patients who sustained blunt trauma and were discovered on cFAST examination to have developed pericardial tamponade from overlying rib or sternal fractures in the emergency departments of two academic level I trauma hospitals in the United States. Why Should an Emergency Physician Be Aware of This? These cases highlight the need for emergency and trauma physicians to be aware of blunt-induced, penetrating trauma to the heart and mediastinum, and for future trauma care guidelines to consider the importance of the cFAST examination.