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Blunt cardiac injury encompasses multiple injuries, including contusion, acute valvular disorders, and chamber rupture. Blunt traumatic cardiac rupture is a very rare occurrence accounting for 0.5% of blunt trauma cases with a very high mortality rate. Coexisting pericardial rupture in patients with cardiac rupture obscures the diagnosis and contributes to mortality. False negative pericardial ultrasound secondary to a concomitant pericardial laceration and subsequent decompression of the cardiac hemorrhage into the ipsilateral pleural space is extremely rare and has only been recently described in the literature. This image depicts a case of traumatic right ventrictular rupture from blunt cardiac injury and highlights the importance of considering an underlying cardiac injury in the presence of a negative FAST pericardial window in patients with a traumatic hemothorax.

clinical practice and cases in emergency medicine

Traumatic Right Ventricular Rupture after Blunt Cardiac Injury: CT Diagnosis after False Negative Pericardial Window on FAST Due to Concomitant Pericardial Rupture