Rajendran Gunaseelan, Babu Guguloth Ramesh, Chandrasekar Vinodha, Kagne Rajeshwari, Nathan Balamurugan
Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Turk J Emerg Med. 2022 Apr 11;22(2):104-107. doi: 10.4103/2452-2473.342803. eCollection 2022 Apr-Jun.
Cardiac tamponade is a cardiac emergency that requires urgent intervention. Cardiac tamponade due to penetrating cardiac injury requires urgent thoracotomy. As per the guidelines, pericardiocentesis can be done as a bridge to thoracotomy. However, no clear guidelines exist on the management of cardiac tamponade due to blunt cardiac injury. In the following case report, we propose a management plan for blunt cardiac injury in the emergency department. In the following case report, we describe a patient with a road traffic accident who had a blunt cardiac injury and had cardiac tamponade for whom we did not do emergency pericardiocentesis. Instead, we managed the patient with iv fluids and blood transfusion and the patient was taken up for immediate emergency thoracotomy. Not all cardiac tamponade requires pericardiocentesis. Cardiac tamponade due to injury to the low-pressure system can be best managed by initial resuscitation followed by emergency thoracotomy. We also propose a management plan for managing a patient with cardiac tamponade due to blunt cardiac injury when the injury can be visible in the low-pressure chambers.
心脏压塞是一种需要紧急干预的心脏急症。穿透性心脏损伤所致的心脏压塞需要紧急开胸手术。根据指南，心包穿刺可作为开胸手术的过渡措施。然而，对于钝性心脏损伤所致心脏压塞的处理，目前尚无明确的指南。在以下病例报告中，我们提出了急诊科钝性心脏损伤的处理方案。在以下病例报告中，我们描述了一名交通事故患者，其患有钝性心脏损伤并发生了心脏压塞，我们未对其进行紧急心包穿刺。相反，我们通过静脉输液和输血对患者进行处理，并立即为患者进行了紧急开胸手术。并非所有心脏压塞都需要心包穿刺。低压系统损伤所致的心脏压塞，最佳处理方法是先进行初步复苏，然后进行紧急开胸手术。当低压腔室可见损伤时，我们还提出了处理钝性心脏损伤所致心脏压塞患者的处理方案。
