Blunt cardiac injury complicated by cardiac tamponade arising from severe structural disruption — ruptured valve, septum, or ventricular wall — in a patient who is haemodynamically stable enough to be transferred to an operating room.
Clinical or echocardiographic evidence of severe cardiac structural injury causing tamponade mandates emergent surgical consultation. The combination of tamponade physiology and structural disruption defines a high-acuity surgical emergency.
In patients able to reach the operating room, management involves a specific cardiac surgical support technique. The complete protocol details the conditions under which it is applied and what follows. The full structured regimen is available below.
It is imperative that patients with clinical or echocardiographic evidence of severe cardiac injury, i.e., ruptured valve, septum, or ventricular wall causing cardiac tamponade, receive emergent surgical consultation.
Among unstable patients who may not survive transfer to an operating room, emergency department thoracotomy, rather than pericardiocentesis, may be the best treatment for cardiac tamponade.
However, the use of cardiopulmonary bypass has been reported should such measures be unsuccessful and available.
DOI: 10.1186/s13019-023-02146-z