Blunt cardiac rupture with prehospital pulseless electrical activity: a rare successful experience.
Blunt cardiac rupture is highly associated with mortality. In the recent literature, the reported mortality rates of cardiac rupture ranged from 59.7% to 100%. The probability of survival for those with prehospital pulseless electrical activity was extremely low. This case report describes a rare example of survival of a female patient with life-threatening cardiac rupture and cardiac tamponade after a major car accident. The victim developed pulseless electrical activity at admission. She recovered from the accident, however, without developing any signs of neurologic deficits. This case study emphasizes the value of the primary survey of patients and prompt and accurate interventions, including focused abdominal sonography for trauma, pericardiocentesis, and an urgent thoracotomy in the operating room for primary repair of cardiac rupture without applying a cardiopulmonary bypass system. The study showed that early diagnosis and aggressive interventions are crucial factors to the successful outcome of patient's survival.
Lu
Li-Hua
LH
Department of Emergency Medicine, Mackay Memorial Hospital, Mackay Junior College of Nursing, Taipei, Taiwan, Republic of China.
Choi
Wai-Mau
WM
Wu
Hsueh-Ru
HR
Liu
Hung-Chang
HC
Chiu
Wen-Ta
WT
Tsai
Shin-Han
SH
D000328:Adult; D005260:Female; D006335:Heart Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D020519:Pericardiocentesis; D011674:Pulse; D013616:Tachycardia, Sinus / Q000209:etiology; D013908:Thoracotomy; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*