Herniation of the heart into the right pleura following blunt chest trauma--an unusual presentation

A 21-year-old male patient had sustained a blunt chest and abdominal trauma during a traffic accident. All the major injuries were on the left side. On the second day, a massive shift of the mediastinum to the right was noted. Further investigations raised the suspicion of herniation of the heart into the right pleural cavity. However, the patient's hemodynamic stability did not fit into the picture. Echocardiography and CT scan helped reinforce our suspicion. Herniation was confirmed at the operation, which was performed through median sternotomy. The patient recovered well without complications.