Blunt Pericardial Rupture with Cardiac Herniation: Unusual Radiographic Findings

The Cardiac Pendulum: Blunt Rupture of the Pericardium with Strangulation of the Heart

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.