Case ReportCoronary Artery Bypass Surgery in Undiagnosed Traumatic Pericardial Rupture—25 Years Later
Introduction
Traumatic rupture of pericardium is rare and usually associated with other major injuries with a mortality ranging from 30% to 65%. This condition presents a diagnostic and management dilemma.
Section snippets
Case Report
A 55-year-old man was admitted to the hospital for elective coronary artery bypass surgery for increasing exertional angina. He had a past history of blunt thoracic trauma following a motor vehicle accident sustained 25 years ago. During that accident, he had suffered from fractured ribs on the left side and a dislocated left shoulder, which was treated conservatively with a few days admission in hospital.
His physical examination showed that the apex beat was laterally displaced towards the
Discussion
This patient must have sustained a left pleuropericardial rupture during the initial trauma which remained undiagnosed. Gradually the heart must have herniated into the left chest without causing any hemodynamic compromise.
Traumatic pericardial rupture presents with diagnostic and management problems. Review of the literature1, 2 shows the following: the incidence of traumatic pericardial rupture is 1 in 1000 patients admitted to a trauma centre. Eighty percent of cases were diagnosed
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