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J Thorac Cardiovasc Surg 2007;133:829-830
© 2007 The American Association for Thoracic Surgery

Brief Communication

Tension pneumopericardium and pneumothorax during spontaneous ventilation

^a Cardiothoracic Surgery Department, Clinica Pineta Grande Castelvolturno (CE), Naples, Italy
^b Cardiac Surgery Department, University Federico II, Naples, Italy.

Received for publication September 17, 2006; accepted for publication November 8, 2006.

^_* Address for reprints, Francesco Petteruti, MD, Via Lauria 38, 81100 Caserta, Italy. (Email: tea41273@libero.it).

The first 20% of the full text of this article appears below.

Pneumopericardium is a complication of blunt or penetrating injuries of the chest, and it usually does not cause hemodynamic compromise. Tension pneumopericardium is less common and may indeed be life-threatening. It usually occurs in patients receiving assisted ventilation.^1,2 We report a case of tension pneumopericardium in a patient during spontaneous ventilation.

Clinical Summary

A 45-year-old man was involved in a high-speed motor vehicle crash. A prolonged extrication was required and the initial evaluation at the scene revealed fractures of the ribs, right arm, and left femur as well as cranial trauma without neurologic deficit. He was in stable condition and did not require mechanical ventilation. On admission to the hospital, the patient was in respiratory distress, agitated, and had chest and abdominal pain. Oxygen saturation was 90% on 50% oxygen delivered by face mask, systolic blood pressure 90 mm Hg, heart rate 130 beats/min, and hemoglobin level 12.8 g/dL. Physical examination revealed a large subcutaneous thoracic emphysema with asymmetry of the chest, and the pulmonary sounds . . . [Full Text of this Article]

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