Delayed Post-Traumatic Tamponade: The End of the Tunnel

Abstract

Cardiac tamponade is a diastolic ventricular insufficiency responsible for a reduction in cardiac output. Most often the consequence of cardiac surgery or neoplasia, it can follow a thoracic myocardial contusion, even several days after the trauma.

The case presented here is that of a 28-year-old man who suffered a thoracic crush injury following a traffic accident, responsible for a bilateral hemopneumothorax, a bilateral flail chest, and a myocardial contusion. The patient presented 10 days after the trauma with hemodynamic deterioration related to a delayed cardiac tamponade on a 1 L hemopericardium.

The interest of this case lies in the presentation of this rare and urgent pathology, in the differential diagnoses and cognitive biases that led to a diagnostic delay, as well as in the description of the various therapeutic and anesthetic strategies to be known to effectively manage these patients.