Emergency Management of Blunt Cardiac Tamponade: A Report of Two Cases

Blunt cardiac tamponade is an uncommon but life-threatening consequence of thoracic trauma. Early recognition and prompt surgical management are essential to reduce mortality. In Case 1, a 35-year-old male presented nine hours after a fall from 10 ft with hypotension, bradycardia, and muffled heart sounds. Extended focused assessment with sonography in trauma (EFAST) revealed pericardial effusion suggestive of tamponade. The patient was transferred to the operating room and underwent a clamshell thoracotomy with pericardial decompression, evacuating 100 mL of hematoma. He stabilized and was subsequently managed for associated spinal injuries. In Case 2, a 19-year-old female presented to the trauma center following a road traffic injury. Initial assessment revealed hypotension, bradycardia, muffled heart sounds, and diminished bilateral breath sounds. EFAST demonstrated pericardial fluid indicative of tamponade. ED thoracotomy evacuated 200 mL of hemopericardium. The patient later recovered and was discharged. These cases underscore the critical importance of early diagnosis and emergency thoracotomy in the management of blunt cardiac tamponade.