• Masanori Murakami, H Ito, M Hayashi, S Ikenaga, M Nishida, Y Minami, K Suzuki, H Okada, and K Hamano.
• First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
• Kyobu Geka. 2006 Feb 1;59(2):126-30.

AbstractAtrial rupture without other major injury following blunt chest trauma is rare, but carries high mortality rate. Here we report 3 cases of blunt atrial rupture. All patients presented with hypotension and loss of consciousness. Echocardiography and computed tomography (CT) demonstrated pericardial effusion in all cases. All patients underwent surgery with a median sternotomy. Tear of the right atrium was seen in 2 patients, and no remarkable tear was seen in 1 patient. One of the 3 patients underwent surgery using cardiopulmonary bypass because he showed cardiogenic shock. Pericardiocentesis before the operation was not effective. All patients were discharged uneventfully. Echocardiography and CT were useful for diagnosis of cardiac rupture. In most reported cases, the cardiac tear has been repaired without using cardiopulmonary bypass. However, it is difficult to diagnose location of the tear, therefore, the repair became safer using cardiopulmonary bypass for the patients with cardiogenic shock. This article has described the mechanisms and generation of blunt chest trauma lesions.

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