| Peer-Reviewed

Right Atrial Rupture Due to Non-thoracic Deceleration Injury

Received: 23 March 2022     Accepted: 19 April 2022     Published: 28 July 2022
Views:       Downloads:
Abstract

Right atrial rupture is predominantly caused by direct thoracic trauma. Non thoracic injuries leading to cardiac rupture is rare. Cardiac injury is responsible for a majority of the deaths following trauma. Exact figures are unavailable in our country. With the increasing number of high-speed vehicular accidents, many patients sustain cardiac rupture, but are not transported to the hospital in time and they succumb to the injuries. There are reports of patients having survived following surgery for cardiac rupture. Most of these are secondary to direct trauma. We describe our experience of treating two cases of cardiac rupture due to non-thoracic trauma and the anatomical and pathophysiological rationale for the occurrence of this rare, but eminently treatable injury. With modern technology, it is easy to diagnose these injuries by echocardiography, if the treating team is aware of the condition. Most patients who survive the initial hours have injury localized to the right atrium. There may be associated injuries to the other cardiac chambers, and all require rapid diagnosis and treatment. The key to diagnosis and treatment is in high index of suspicion of this injury within the golden hour; recognition of hemopericardium on echocardiogram and emergency explorative surgery and repair of the atrial tear.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 8, Issue 4)
DOI 10.11648/j.ijcts.20220804.11
Page(s) 39-41
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Cardiac Rupture, Atrial Injury, Trauma, Shock

References
[1] Bright, E. F. and Beck, C. F.: Non-penetrating wounds of the heart. A clinical and experimental study. Amer. Heart J., 10: 293-321, 1935.
[2] Teixeira PG, Inaba K, Oncel D, DuBose J, Chan L, Rhee P, et al. Blunt cardiac rupture: a 5 year NTDB analysis. J Trauma 2009; 67 (4): 788–791.
[3] Leavitt BJ, Meyer JA, Morton JR, Clark DE, Herbert WE, Hiebert CA. Survival following nonpenetrating traumatic rupture of cardiac chambers. Ann Thorac Surg 1987; 44 (5): 532–535.
[4] Karalis DG, Victor MF, Davis GA, McAllister MP, Cova-lesky VA, Ross JJ Jr, et al. The role of echocardiography in blunt chest trauma: a transthoracic and transesophageal echocardiographic study. J Trauma 1994; 36 (1): 53–58.
[5] Hirai S, Hamanaka Y, Mitsui N, Isaka M, Kobayashi T. Successful emergency repair of blunt right atrial rupture after a traffic accident. Ann Thorac Cardiovasc Surg 2002; 8 (4): 228–230.
[6] Figueiredo AM, Poggetti RS, Quintavalle FG, et al. Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness. World Journal of Emergency Surgery. 2007; 2: 5. doi: 10.1186/1749-7922-2-5.
[7] T. Maraqa, M. A. T. Mohamed, K. L. Wilson, V. Perinjelil, G. R. Sachwani-Daswani, L. Mercer. Isolated right atrial rupture from blunt trauma: a case report with systematic review of a lethal injury. J. Cardiothorac. Surg., 14 (1) (2019), p. 28.
[8] Cecil S. Johnny, Mayank Vasudeva, Julian Gooi, Benedict Waldron, Ee Jun Ban, Nathan Durbridge, Mark C. Fitzgerald. Right atrial appendage rupture and cardiac tamponade secondary to blunt trauma. Trauma Case Reports, Volume 38, 2022, 100620, ISSN 2352-6440, doi.org/10.1016/j.tcr.2022.100620.
[9] M. C. Fitzgerald, M. S. Yong, K. Martin, A. Zimmet, S. F. Marasco, J. Mathew, et al. Emergency department resuscitative thoracotomy at an adult major trauma Centre: outcomes following a training programme with standardised indications. Emerg. Med. Australas., 32 (4) (2020), pp. 657-662.
[10] Christopher Groombridge, Amit Maini, Francis O'Keeffe, Mike Noonan, De Villiers Smit, Joseph Mathew, Mark Fitzgerald, Resuscitative thoracotomy, Emergency Medicine Australasia, 10.1111/1742-6723.13689, 33, 1, (138-141), (2020).
Cite This Article
  • APA Style

    Sujith Neralakere Suresha, Paritosh Ballal, Navin Lal. (2022). Right Atrial Rupture Due to Non-thoracic Deceleration Injury. International Journal of Cardiovascular and Thoracic Surgery, 8(4), 39-41. https://doi.org/10.11648/j.ijcts.20220804.11

    Copy | Download

    ACS Style

    Sujith Neralakere Suresha; Paritosh Ballal; Navin Lal. Right Atrial Rupture Due to Non-thoracic Deceleration Injury. Int. J. Cardiovasc. Thorac. Surg. 2022, 8(4), 39-41. doi: 10.11648/j.ijcts.20220804.11

    Copy | Download

    AMA Style

    Sujith Neralakere Suresha, Paritosh Ballal, Navin Lal. Right Atrial Rupture Due to Non-thoracic Deceleration Injury. Int J Cardiovasc Thorac Surg. 2022;8(4):39-41. doi: 10.11648/j.ijcts.20220804.11

    Copy | Download

  • @article{10.11648/j.ijcts.20220804.11,
      author = {Sujith Neralakere Suresha and Paritosh Ballal and Navin Lal},
      title = {Right Atrial Rupture Due to Non-thoracic Deceleration Injury},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {8},
      number = {4},
      pages = {39-41},
      doi = {10.11648/j.ijcts.20220804.11},
      url = {https://doi.org/10.11648/j.ijcts.20220804.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20220804.11},
      abstract = {Right atrial rupture is predominantly caused by direct thoracic trauma. Non thoracic injuries leading to cardiac rupture is rare. Cardiac injury is responsible for a majority of the deaths following trauma. Exact figures are unavailable in our country. With the increasing number of high-speed vehicular accidents, many patients sustain cardiac rupture, but are not transported to the hospital in time and they succumb to the injuries. There are reports of patients having survived following surgery for cardiac rupture. Most of these are secondary to direct trauma. We describe our experience of treating two cases of cardiac rupture due to non-thoracic trauma and the anatomical and pathophysiological rationale for the occurrence of this rare, but eminently treatable injury. With modern technology, it is easy to diagnose these injuries by echocardiography, if the treating team is aware of the condition. Most patients who survive the initial hours have injury localized to the right atrium. There may be associated injuries to the other cardiac chambers, and all require rapid diagnosis and treatment. The key to diagnosis and treatment is in high index of suspicion of this injury within the golden hour; recognition of hemopericardium on echocardiogram and emergency explorative surgery and repair of the atrial tear.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Right Atrial Rupture Due to Non-thoracic Deceleration Injury
    AU  - Sujith Neralakere Suresha
    AU  - Paritosh Ballal
    AU  - Navin Lal
    Y1  - 2022/07/28
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijcts.20220804.11
    DO  - 10.11648/j.ijcts.20220804.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 39
    EP  - 41
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20220804.11
    AB  - Right atrial rupture is predominantly caused by direct thoracic trauma. Non thoracic injuries leading to cardiac rupture is rare. Cardiac injury is responsible for a majority of the deaths following trauma. Exact figures are unavailable in our country. With the increasing number of high-speed vehicular accidents, many patients sustain cardiac rupture, but are not transported to the hospital in time and they succumb to the injuries. There are reports of patients having survived following surgery for cardiac rupture. Most of these are secondary to direct trauma. We describe our experience of treating two cases of cardiac rupture due to non-thoracic trauma and the anatomical and pathophysiological rationale for the occurrence of this rare, but eminently treatable injury. With modern technology, it is easy to diagnose these injuries by echocardiography, if the treating team is aware of the condition. Most patients who survive the initial hours have injury localized to the right atrium. There may be associated injuries to the other cardiac chambers, and all require rapid diagnosis and treatment. The key to diagnosis and treatment is in high index of suspicion of this injury within the golden hour; recognition of hemopericardium on echocardiogram and emergency explorative surgery and repair of the atrial tear.
    VL  - 8
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Cardiothoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India

  • Department of Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India

  • Department of Cardiothoracic Surgery, St. John’s Medical College, Bangalore, India

  • Sections