• Joseph Offenbacher, Rachel Liu, Zeah Venitelli, Dylan Martin, Kobi Fogel, Vincent Nguyen, and Peter Kyunghwan Kim.
• Department of Emergency Medicine, Jacobi and Montefiore Medical Centers, Albert Einstein College of Medicine, Bronx, New York.
• J Emerg Med. 2021 Sep 1; 61 (3): e40-e45.

BackgroundSevere cardiac injury caused by penetrating rib or sternal fractures after blunt chest trauma is a rare clinical entity that has been described in only a few case reports over the last half-century. As a result, questions have arisen about the utility of the cardiac component in the Focused Assessment with Sonography in Trauma (cFAST) examination in evaluating blunt trauma patients.Case ReportWe present a series of 3 patients who sustained blunt trauma and were discovered on cFAST examination to have developed pericardial tamponade from overlying rib or sternal fractures in the emergency departments of two academic level I trauma hospitals in the United States. Why Should an Emergency Physician Be Aware of This? These cases highlight the need for emergency and trauma physicians to be aware of blunt-induced, penetrating trauma to the heart and mediastinum, and for future trauma care guidelines to consider the importance of the cFAST examination.Copyright © 2021 Elsevier Ltd. All rights reserved.

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