遅発した外傷性心タンポナーデの1例

Abstract

A case of delayed cardiac tamponade after chest trauma is reported. A 57 -year-old man was admitted to a local hospital because of chest wall contusion in a traffic accident. Fifty-five days after discharge, the patient developed dyspnea on effort and was admitted to our hospital. A chest radiograph showed cardiomegaly. Electrocardiogram showed no ST-T changes. Echocardiogram revealed massive pericardial effusion without asynergy of left ventricular wall movement. Pericardiocentesis was performed, which drained 760 ml of bloody fluid. No evidence of acute pericarditis, metastatic pericardial disease or uremic pericaditis was found and post-cardiac injury syndrome was suspected. Delayed pericardial effusion, which is part of post-cardiac injury syndrome, usually occurs 2-4 weeks after chest trauma. Because the interval between the chest trauma and pericar- dial fluid accumulation in this case was unusually long, we report the case and review the previous reports of post-traumatic cardiac tamponade.