Traumatic rupture of the pericardium

Isolated pericardial rupture due to nonpenetrating chest injury was diagnosed in a 21 year old man with multiple traffic injuries. Radiologic examination showed displacement of the heart to the left and therefore gave rise to a suspicion of pericardial rupture. The diagnosis was proved by establishing left-sided pneumothorax when the air passed into the pericardial cavity. The patient had no cardiac symptoms. His electrocardiogram, cardiac volume and hemodynamics at rest and during exercise were entirely normal. The physiologic and clinical implications of pericardial defects are briefly discussed.