title: Successful diagnosis of pericardial rupture caused by blunt chest trauma using contrast ultrasonography.
abstract: A 65-year-old male developed acute myocardial infarction due to coronary artery dissection and tricuspid valve injury after blunt chest trauma. Acute myocardial infarction was treated by coronary artery intervention; however, refractory heart failure with pleural effusion remained. The first transthoracic echocardiography (TTE) on admission failed to clearly visualize the tricuspid valve and right ventricle due to poor image quality. A follow-up TTE with contrast ultrasonography revealed pericardial rupture in addition to tricuspid regurgitation. Ruptures of the tricuspid papillary muscle and pericardium were confirmed during surgery and were repaired successfully. Blunt chest trauma results in various cardiac injuries including cardiac rupture, intramural hematoma, valvular injury, coronary artery injury, and electrical disturbances, leading to critical conditions and high mortality. Of such blunt trauma-induced injuries, coronary artery dissection, tricuspid valve injury, and pericardial rupture caused by blunt chest trauma are rare, and simultaneous occurrence of the three types of injuries that were successfully repaired has not been reported. In addition, this case indicates the utility of contrast ultrasonography for diagnosis of pericardial rupture caused by blunt chest trauma.
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan. y.tatekoshi@sapmed.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tatekoshi
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan.|Department of Infection Control and Clinical Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yuda
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogasawara
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Muranaka
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kokubu
authors.affiliation: Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hase
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Tachibana
authors.affiliation: Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Tsuchihashi
authors.affiliation: Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Higami
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-0061, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Miura
mesh_terms: D000368:Aged; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D012421:Rupture / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery
chemical_list: D003287:Contrast Media
keywords: Blunt chest trauma; Contrast ultrasonography; Coronary artery dissection; Pericardial rupture; Tricuspid regurgitation