International Journal of Cardiovascular and Thoracic Surgery

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report

Background: Right atrial appendage rupture from blunt trauma is very uncommon, but is associated with a high mortality rate. Moreover, due to the paucity in available literature, our knowledge of the condition is still limited. Purposes: To emphasize a high degree of clinical suspicion in a case of cardiac tamponade after blunt chest trauma, quick diagnostic confirmation and urgent optimal management of such cases to save the patient and to avoid unnecessary and unacceptable delays. Case presentation: The author reports a 22-year-old female involved in a blunt chest trauma who was initially misdiagnosed and delayed management in a regional hospital, then transferred to our institution in a status of severe hypovolemic shock and cardiac tamponade with unconsciousness, intubation and mildly dilated and weakly reactive eyes/pupils. Fortunately, the patient was saved with quick diagnostic confirmation, urgent sternotomy and surgical repair of atrial appendage laceration for hemostasis associated with intra- and post-operatively intensive resuscitations. Conclusion: The important key to right atrial rupture diagnosis is a high degree of clinical suspicion in a case of cardiac tamponade following blunt chest trauma, especially with a hemodynamically unstable or compromised status. Aggressive resuscitation, prompt diagnosis, and urgent operation to repair the cardiac lesions are cornerstones to achieving an optimal outcome.

Isolated Right Atrial Appendage Rupture, Right Atrial Rupture, Cardiac Rupture, Blunt Chest Trauma, Cardiac Tamponade

APA Style

Tran Thuc Khang, Huynh Khiem Huy, Bui Trong Dat, Dang Le Hong Ngan, Trinh Cong Dong, et al. (2023). Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report. International Journal of Cardiovascular and Thoracic Surgery, 9(5), 67-70. https://doi.org/10.11648/j.ijcts.20230905.12

ACS Style

Tran Thuc Khang; Huynh Khiem Huy; Bui Trong Dat; Dang Le Hong Ngan; Trinh Cong Dong, et al. Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(5), 67-70. doi: 10.11648/j.ijcts.20230905.12

AMA Style

Tran Thuc Khang, Huynh Khiem Huy, Bui Trong Dat, Dang Le Hong Ngan, Trinh Cong Dong, et al. Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report. Int J Cardiovasc Thorac Surg. 2023;9(5):67-70. doi: 10.11648/j.ijcts.20230905.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Johnny C. S, Vasudeva M., Gooi J., Waldron B., et al. “Right atrial appendage rupture and cardiac tamponade secondary to blunt trauma”. Trauma Case Reports, Elsevier, 2022 (38): 1-4.
2. Ammannaya G. K. K., Raut C., Mohapatra C. K. R. “Cardiac Tamponade from Isolated Right Atrial Rupture: A Rare Presentation of Blunt Chest Trauma Without Rib Fracture.” The Journal of Cardiothoracic Trauma. 2016; 1 (1): 13–15.
3. Raid Y. “Blunt cardiac trauma: A review of the current knowledge and management,” Annals of Thoracic Surgery, 2014; 98 (3): 1134–1140.
4. Maraqa T., Mohamed M., Wilson K. L., et al. “Isolated right atrial rupture from blunt trauma: A case report with systematic review of a lethal injury,” Journal of Cardiothoracic Surgery, 2019; 14 (3): 6-8.
5. Gajjar A. H., Altherton J. T. “Isolated right atrial tear following blunt chest trauma,” Japanese Heart Journal, 2011; 41 (4): 535–540.
6. Ayyan M. A., Aziz T., Sherif A. E., et al., “Blunt Cardiac Injury: Case Report of Salvaged Traumatic Right Atrial Rupture,” Turkish Journal of Trauma and Emergency Surgery. 2015; 21 (6): 527-530.
7. Rakesh H., Lafayette N., Sywak M., Ricketts G., Otero J., Kurtzman S., “Isolated right atrial appendage rupture following blunt chest trauma.” Trauma Case Reports journal. Elservier, 2018; 13: 26-29.
8. Hiroaki O., Kenji S., Hironobu H., Takahiro T., “A case report: hemothorax caused by rupture of the left atrial appendage,” Surgical Case Reports, 2016; 2 (1): 2-4.
9. EL-Andari1 R., O’Brien D., Bozso S. J., “Blunt cardiac trauma: a narrative review.” Mediastinum, 2021; 5 (28): 1–13.
10. Rajendran G., Babu G. R., Chandrasekar V., Kagne R., “Cardiac tamponade due to right atrial rupture.” Turkish Journal of Emergency Medicine, 2022; 22: 104, 7.
11. Pinni S., Kumar V., “Blunt Cardiac Rupture: A Diagnostic Challenge.” Journal of Clinical and Diagnostic Research., 2016; 10 (11): PD27–PD28.
12. Read M. D., Sunderland M. S., and Laface A., “Survivor of Right Atrial Appendage Rupture Following Blunt Chest Trauma.” The American Surgeon, 2022; 88 (5). https://doi.org/10.1177/00031348211054068
13. Suresha S. N., Ballal P., “Right Atrial Rupture Due to Non-thoracic Deceleration Injury.” International Journal of Cardiovascular and Thoracic Surgery, 2022; 8 (4): 39–41.
14. Alessandro F., Valerio M., Irene Adelaide S., Pierluca Z., Pietra D., Campobasso B., “Isolated Right Atrial Rupture From Blunt Chest Trauma in Motor Vehicle Collisions: Mechanisms of Injury and Outcomes.” The American Journal of Forensic Medicine and Pathology, 2021; 42 (1): 67–69.
15. T. T. Yavuz S., Eris C., Toktas F., Goncu T., Ata Y., “Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting.” Asian Biomedicine Vol. 8 No. 1, pp. 119–122, 2014.
16. Park C. Y. “Rupture of the Right Atrium Following a Closed-Chest Cardiac Massage” Trauma Image Proced, 2017; 2: 64–65.
17. Maraqa T., Mohamed M. A. T., Wilson K. L., et al. “Isolated right atrial rupture from blunt trauma: A case report with systematic review of a lethal injury,” Journal of Cardiothoracic Surgery, 2019; 14 (1): 2-7.
18. Brewer B., and Zarzaur B. L., “Cardiac Contusions,” Current Trauma Reports, 2015; 1 (4): 232–236.
19. Shin-Ah Son, Joon Yong Cho, Gun-Jik Kim, et al. "Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports." Yeungnam Univ J Med, 2021; 38 (4): 356-360.