Extrapericardial cardiac tamponade after blunt chest trauma

Extrapericardial cardiac tamponade secondary to traumatic hemorrhage of the thymus

This report describes a 90-year-old man who sustained blunt chest trauma that progressed to circulatory failure from an enlarging anterior mediastinal hematoma. Emergent sternotomy was performed, revealing a hematoma primarily involving the thymus that was promptly evacuated. Extrapericardial cardiac tamponade is an uncommon event that occurs when fluid collects within the mediastinum but outside the pericardium. Hemodynamically significant hemorrhage of the thymus is rare because the gland begins to involute early in development. To our knowledge, cardiac tamponade secondary to traumatic hemorrhage of the thymus has not been previously described. Early recognition and hematoma evacuation can be lifesaving.

Extra-Pericardial Tamponade due to Internal Thoracic Artery Rupture after Blunt Trauma: A Case Report

<p>Cardiac tamponade is an acute life-threatening condition that predominantly involves the intra-pericardial space; however, an expanding mediastinal hematoma can also sometimes cause cardiac tamponade. Here we describe the case of a 45-year-old male driver in whom a traffic accident resulted in rupture of the left internal thoracic artery (ITA), extra-pericardial hematoma, and sternal fracture. After resuscitation, he was scheduled to undergo angio-embolization to repair the ruptured left ITA, but he suddenly developed cardiac tamponade that required a decompressive sternotomy. Nevertheless, the patient had an uncomplicated recovery, and this case suggests that extra-pericardial cardiac tamponade should be considered as a possible consequence of retro-sternal hematoma due to traumatic ITA rupture.</p>

Extrapericardial cardiac compression syndrome

A case report is described of a patient presenting with extrapericardial cardiac compression resulting from massive ascites. The history and electrocardiographic findings initially obscured the proper diagnosis. Extrapericardial cardiac compression syndromes resulting from massive ascites pose a particular challenge in that even when the diagnosis of tamponade is made, failure to recognize the true cause of impaired cardiac filling can lead to unnecessary instrumentation of an otherwise incidental pericardial effusion. This unique case is discussed with other group of conditions of pericardial compressive syndromes.