Traumatic cardiac luxation

Excerpt

A 38-year-old male motorcycle passenger who experienced a high kinetic energy traffic accident was transferred to the ICU. On admission, the patient was hemodynamically unstable, requiring massive volume expansion, transfusions and high doses of norepinephrine. A right pneumothorax was immediately evacuated. Thoracic CT showed a luxation of the heart into the right pleural space. There were no cardiac cavity or great vessel strangulation signs (Fig. 1); thus, hemodynamic instability was attributed to hemorrhagic shock and control of the bleeding was prioritized. Afterwards, as the patient's hemodynamics stabilized and because he had a severe traumatic brain injury, it was decided not to surgically reduce the heart. Complete reduction of the luxation was assessed on CT on day 4.

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