Cardiac herniation

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[edit] Discussion of Cardiac herniation

  • Pericardial rupture with cardiac herniation is a rare, highly lethal injury with most patients dying before arrival at a hospital.
  • Diagnosis in survivors is often delayed because initial chest radiography results are normal or show nonspecific abnormalities before cardiac herniation through the pericardial tear.
  • Pericardial tears range from short and insignificant to long tears that may lead to cardiac herniation.
  • Tears 8-12 cm in length are associated with cardiac herniation, 90% of which occur along the left pleuropericardium.

[edit] Imaging Findings for Cardiac herniation

  • CT has shown pericardial tears before cardiac herniation and herniation itself.
  • Signs of a tear include focal pericardial discontinuity; pneumopericardium; and interposition of lung between the aorta and pulmonary artery, heart and diaphragm, or right atrium and right ventricular outflow tract— signs similar to congenital absence of the pericardium.
  • The primary sign of herniation is cardiac displacement when no large pleural effusion, atelectasis, or tension pneumothorax accounts for this displacement.
  • Pneumopericardium is nonspecific, but a large volume of unilateral gas within the pericardium is more diagnostic of cardiac herniation, and has been termed the empty pericardial sac.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Cardiac herniation