[Cardiac arrest caused by pericardial heart dislocation]

[Traumatic rupture of the pericardium. A rare diagnosis]

Rupture of the pericardium is a rare complication of blunt chest trauma. The diagnosis is difficult and if it remains unrecognized, severe complications such as heart herniation may occur. We report the case of a 19-year-old patient with a traumatic rupture of the pericardium. The diagnosis was suggested by a pneumopericardium seen on the chest radiograph and CT-scan. Emergency thoracotomy enabled localisation of the tear, assessment of its size, and reparation of the tear to prevent heart herniation.

[Early diagnosis of traumatic extra-pericardial luxation of the heart. Value of tomodensitometry. Apropos of a case]

Heart luxation is a rare complication of chest trauma. The rupture of pericardium must be diagnosed as soon as possible, particularly before prolonged orthopaedic surgery for multitrauma, as a cardiac arrest may occur during anaesthesia. This report underlines the difficulties of diagnosis in a 40-year-old patient with head trauma, chest trauma and multiple fractures. The diagnosis was suspected on unstable blood pressure and left lung atelectasis. The computed tomography showed herniation of the left ventricle. Emergency thoracotomy showed the left rupture of pericardium with complete left heart dislocation. Orthopaedic operation was carried out three days later. Computed tomography in multitrauma patients, seems to be decisive for early diagnosis of heart luxation. Emergency thoracotomy is essential.