Treatment strategy of cardiac rupture due to blunt trauma

: Cardiac trauma is common in blunt injuries of the chest. However, survival after a cardiac rupture is not common, and only a certain percentage of the patients reach the hospital alive. We report on 3 cases of successful treatment of cardiac rupture due to blunt trauma; one by emergency surgical repair, and the others, conservative medical treatment. Echocardiography and computed tomography demonstrated pericardial effusion in all cases, and emergency pericardial drainage was performed. Gas analyses of arterial blood and pericardial effusion were made simultaneously. When the oxygen saturation levels of the pericardial effusion were lower than those of the arterial blood, we suspected the cardiac injury to be right-sided. When they were almost at the same level, we suspected it to be left-sided. Simultaneous gas analysis of arterial blood and pericardial effusion is considered to be an easy and useful diagnostic method to decide not only treatment strategy, but also operative approach and procedure in patients suffering from cardiac tamponade following cardiac injuries.