Unexpected Cardiac Arrest due to Extrapericardial Tamponade:
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Introduction
In the presence of a post-traumatic hemomediastinum an aortic contrast-enhanced CT scan [1] is indicated. If vascular lacerations are reliably ruled out, the hemomediastinum is generally self-limiting.
In the two cases herein presented the growing hematomas generated a progressive compression on the heart that hesitated in cardiac extrapericardial tamponade resulting in cardiac arrest. In both cases the laceration of the left internal mammary artery was confirmed intraoperatively.

Case
A 65 year old man was brought to Emergency Department (ED) after an unintentional fall from 4 meters height. On admission the blood pressure was 110/60 mmHg, the heart rate was 130 bpm, the hemoglobin was 12,6 g/dL and the Glasgow Coma Score was 14. The patient underwent a CT scan but, during imaging acquisition, the clinical parameters worsened rapidly and an oro-tracheal intubation was required to optimize airway management.
The CT scan revealed fracture of the sternum with hemomediastinum probably generated by the tearing of the left internal mammary artery, a complex fracture of D7-D8-D9 with posterior hemomediastinum and a bilateral pleural effusion (Figure 1). Pericardial effusion was reliably ruled out.....

https://www.omicsgroup.org/journals/unexpected-cardiac-arrest-due-to-extrapericardial-tamponade-beware-ofhemomediastinum-2165-7548-1000276.php?aid=60664
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