International Journal of Cardiovascular and Thoracic Surgery

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

Received: 13 September 2023    Accepted: 5 October 2023    Published: 14 October 2023
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Abstract

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.

DOI 10.11648/j.ijcts.20230905.12
Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 5, September 2023)
Page(s) 67-70
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), 2024. Published by Science Publishing Group

Keywords

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

References
[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.
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[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.
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    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

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    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

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    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

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  • @article{10.11648/j.ijcts.20230905.12,
      author = {Tran Thuc Khang and Huynh Khiem Huy and Bui Trong Dat and Dang Le Hong Ngan and Trinh Cong Dong and Tran Quang Thai},
      title = {Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {9},
      number = {5},
      pages = {67-70},
      doi = {10.11648/j.ijcts.20230905.12},
      url = {https://doi.org/10.11648/j.ijcts.20230905.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230905.12},
      abstract = {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.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Isolated Right Atrial Appendage Rupture from Blunt Chest Trauma: A Case Report
    AU  - Tran Thuc Khang
    AU  - Huynh Khiem Huy
    AU  - Bui Trong Dat
    AU  - Dang Le Hong Ngan
    AU  - Trinh Cong Dong
    AU  - Tran Quang Thai
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    DO  - 10.11648/j.ijcts.20230905.12
    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  - 67
    EP  - 70
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20230905.12
    AB  - 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.
    VL  - 9
    IS  - 5
    ER  - 

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Author Information
  • Department of Cardiovascular and Thoracic Surgery, Xuyen A Hospital, Ho Chi Minh, Vietnam

  • Cardiovascular Centre, Tam Anh Hospital, Ho Chi Minh, Vietnam

  • Department of Cardiovascular and Thoracic Surgery, Xuyen A Hospital, Ho Chi Minh, Vietnam

  • Department of Cardiovascular and Thoracic Surgery, Xuyen A Hospital, Ho Chi Minh, Vietnam

  • Department of Cardiovascular and Thoracic Surgery, Xuyen A Hospital, Ho Chi Minh, Vietnam

  • Department of Cardiovascular and Thoracic Surgery, Xuyen A Hospital, Ho Chi Minh, Vietnam

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