Blunt Thoracic Trauma-Induced Mitral Papillary Muscle Avulsion with Pericardial Rupture and Cardiac Herniation: Difficult and Delayed Diagnoses

Author:

McCauley Ross1ORCID,Shariff Faisal2,Steinberg Michael2,Bemenderfer Thomas B.1,Davis Patrick1,Thompson Mark2,Lesh Christopher3,Walsh Mark24ORCID,Evans Edward2

Affiliation:

1. Indiana University School of Medicine, South Bend, IN 46617, USA

2. Memorial Hospital Trauma Center, 615 N. Michigan Street South Bend IN 46601, USA

3. Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA

4. St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA

Abstract

Blunt thoracic trauma (BTT) and the resultant isolated mitral papillary muscle avulsion, pericardial rupture, and cardiac herniation injuries are each rarely diagnosed clinical entities. We describe the first case of combined pericardial tear with cardiac herniation and ruptured mitral papillary muscles following BTT. Preoperative transesophageal echocardiography (TEE) diagnosed the delayed mitral papillary muscle rupture while all previous diagnostic modalities failed to delineate the pericardial rupture and cardiac herniation. Particular emphasis is placed on the clinical and radiologic aspects of the case that would heighten clinical suspicion in the emergency setting where blunt cardiac injury sequelae are suspected and frequently missed.

Publisher

Hindawi Limited

Subject

General Earth and Planetary Sciences,Water Science and Technology,Geography, Planning and Development

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