Five traumatic late cardiac tamponade cases were analyzed. All patients were male, mean age was 26.2, victims of thoracic penetrating stabbing wound in the precordial region, Ziedler area, admitted to a trauma reference center. They were classified by the Ivatury physiological index for cardiac trauma. The first treatment approach was intercostal pleurectomy and volemic resuscitation followed by hemodynamic and respiratory recovery. Patients with cardiac tamponade symptoms were re-admitted within an interval from eight to twenty four days (mean 20 days) in a thoracic surgery service of a tertiary reference hospital. Diagnostic exams confirmed thickening and pericardial effusion associated with a left pulmonary base entrapment in four of the cases which were treated by posterolateral thoracotomy, including partial pericardiectomy and pulmonary decortication. One patient was diagnosed with purulent pericarditis by supplementary exams and underwent a subxiphoid pericardial drainage. Postoperative cardiac arrhythmia occurred in one patient but the others did not develop any complications and there were no tamponade recurrent cases.
Cardiac tamponade; Penetrating wounds; Thoracic injuries; Diagnosis