Survival of a patient with blunt traumatic biatrial rupture

Cardiac rupture after blunt injury of the chest is uncommon and usually fatal. The incidence of biatrial cardiac rupture is rarer and more likely to be lethal. We report a case of biatrial multiple lacerations following blunt chest injury. At referral, the chest film showed left side massive hemothorax. A chest tube was inserted and primary resuscitation was carried out. The patient's vital signs became stable and he was transferred to our hospital for further management. The time from the injury occurring and the patient arriving at our hospital was 117 minutes. Unexplained hypotension was noted on arrival and bedside ultrasonography revealed cardiac tamponade. After emergent pericardiocentesis, the patient's hemodynamics stabilized. Emergency surgery was performed and the patient was discharged without any sequelae. We successfully managed this case through a high index of suspicion, aggressive investigation, and prompt exploration.