Abstract
•Mediastinal hematoma caused by sternal fracture leading to cardiac tamponade it’s a rare presentation.•CT Scan it’s an effective method to diagnose mediastinal hematoma.•High clinical suspicion of extra pericardial tamponade is required when sternal fracture associated with mediastinal hematoma.•The best management for mediastinal hematoma its urgent evocation of the hematoma to decrease the pressure on the heart.
Cardiac tamponade typically results from fluid or gas collection in the pericardial space leading to impairment in the cardiac function.
A 34 years old male patient presented to the ER after a fall from height. X-rays were done which showed no hemothorax or pneumothorax and multiple stable pelvic fractures. Computed tomography (CT) scan for trauma was done after stabilizing the patient and showed sternal fracture with a huge retrosternal hematoma. The patient was intubated immediately, and an Echocardiogram was ordered along with preparation to go to the operation room urgently due to high suspicion of a rare case of cardiac tamponade. but the patient had cardiac arrest and couldn't be revived despite the CPR effort.
This is a very unusual presentation of cardiac tamponade, mediastinal hematoma leading to extra pericardial tamponade. CT scan is an effective method to diagnose extra pericardial tamponade. In addition, to the high clinical suspicion is required. The sole treatment of mediastinal hematoma is an urgent evacuation.
A careful assessment with high clinical suspicion along with CT Scan is the best way to diagnose extra pericardial tamponade cause by sternal fracture.