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Isolated right atrial rupture from blunt trauma: a case report with systematic review of a lethal injury.
Maraqa, Tareq; Mohamed, Mohamed A T; Wilson, Kenneth L; Perinjelil, Vinu; Sachwani-Daswani, Gul R; Mercer, Leo.
Afiliação
  • Maraqa T; Trauma Department, Hurley Medical Center, One Hurley Plaza, Flint, MI, 48503, USA. tareq762003@gmail.com.
  • Mohamed MAT; Department of Surgery, Michigan State University College of Human Medicine, Eyde Building, Suite 600, 4660 S. Hagadorn Road, East Lansing, MI, 48823, USA.
  • Wilson KL; Department of Surgery, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
  • Perinjelil V; Trauma Department, Hurley Medical Center, One Hurley Plaza, Flint, MI, 48503, USA.
  • Sachwani-Daswani GR; Trauma Department, Hurley Medical Center, One Hurley Plaza, Flint, MI, 48503, USA.
  • Mercer L; Trauma Department, Hurley Medical Center, One Hurley Plaza, Flint, MI, 48503, USA.
J Cardiothorac Surg ; 14(1): 28, 2019 Feb 04.
Article em En | MEDLINE | ID: mdl-30717747
BACKGROUND: Isolated right atrial rupture (IRAR) from blunt chest trauma is rare. There are no physical exam findings and non-invasive testing specific to the condition, which result in diagnostic delays and poor outcomes. We present a case of IRAR along with a systematic review of similar cases in the literature. CASE REPORT: A 23-year-old male presented following a motor vehicle accident (MVA). He was bradycardic and hypotensive during transportation; and required intubation. There were contusions along the right chest wall with clear breath sounds, and no jugular venous distension, muffled heart sounds. Hemodynamic status progressively worsened, ultimately leading to his death. However, no external sources of bleeding or evidence of cardiac tamponade was found. METHODS: A search of PubMed, Ovid, and the Cochrane Library using: (Blunt OR Blunt trauma) AND (Laceration OR Rupture OR Tear) AND (Right Atrium OR Right Atrial). Articles were included if they were original articles describing cases of IRAR. RESULTS: Forty-five reports comprising seventy-five (n = 75) cases of IRAR. CONCLUSION: IRAR most commonly occurs following MVAs as the result of blunt chest trauma. Rupture occurs at four distinct sites and is most commonly at the right atrial appendage. IRAR is a diagnostic challenge and requires a high index of suspicion, as patients' hemodynamics can rapidly deteriorate. The presentations vary depending on multiple factors including rupture size, pericardial integrity, and concomitant injuries. Cardiac tamponade may have a protective effect by prompting the search for a bleeding source. A pericardial window can be diagnostic and therapeutic in IRAR. Outcomes are favourable with timely recognition and prompt surgical intervention.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos não Penetrantes / Apêndice Atrial / Traumatismos Cardíacos Tipo de estudo: Etiology_studies / Systematic_reviews Limite: Adult / Humans / Male Idioma: En Revista: J Cardiothorac Surg Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos não Penetrantes / Apêndice Atrial / Traumatismos Cardíacos Tipo de estudo: Etiology_studies / Systematic_reviews Limite: Adult / Humans / Male Idioma: En Revista: J Cardiothorac Surg Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido