• Journal of Chest Surgery
• /
• v.34 no.2
• /
• pp.173-175
• /
• 2001

흉부둔상에 의한 심장파열은 50% 이상의 치사율을 갖는 질환으로 응급실에 도착하기 전에 사망하는 경우가 대부분이다. 일반적으로 전형적인 심장압전을 동반하기 때문에 이학적 소견이나 심장초음파 또는 흉부전산화 단층촬영으로 진단이 가능하다. 그러나 저자의 경우와 같이 심장압전의 징후가 없이 중증 우측혈흉만 있는 경우 심장파열을 진단하는 것은 어렵다. 만약 고속의 자동차사고로 인한 흉부둔상을 받은 환자에서 늑골골절이 없이 우측에 중증의 혈흉이 있어 응급개흉술을 받아야 한다면 심장파열의 가능성을 염두에두고 수술을 계획하는 것이 필요하다고 생각한다. 본 인하대학교 흉부외과학 교실에서는 흉부둔상에 의한 중증우측 혈흉과 심낭파열을 동반한 심장파열 2례를 심패바이패스와 자가수혈 장치를 이용하여 효과적으로 치료하였기에 보고하는 바이다.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1398-1400
• /
• 1996

The cardiac anatomic position immediately beneath the sternum leaves it vulnerable to injury when this bone is fractured. Cardiac rupture, however, is uncommon but survival following this injury is rare. We report the case of one patient who survived right ventricle perforation resulting from sternal fracture. The patient developed signs of pericardial tamponade and was brought to the operating theatre immediately for surgery through the emergency anterolateral thoracotomy Perforation of th right ventricle was repaired by direct closure without cardiopulmonary bypass. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and surgery.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.95-97
• /
• 2008

Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.633-635
• /
• 2008

Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.

• Journal of Chest Surgery
• /
• v.40 no.1 s.270
• /
• pp.66-68
• /
• 2007

Traumatic cardiac injury is an extremely serious medical condition. It is possible to overlook a cardiac injury where there is no chest wall trauma. We here report the 47-year-old woman who got a crach car accident and had a tear of the right atrium. The distortion force from a decelerating injury may cause cardiac rupture at a fixed point. The most common symptom that alerts the clinician to a potentially fatal cardiac injury is the change in vital signs. Therefore cardiac injury should be considered in any patient with unexplained hypotension who has experienced decelerating trauma, even without external injury to the chest wall.

• Journal of Chest Surgery
• /
• v.38 no.10 s.255
• /
• pp.717-720
• /
• 2005

Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.

• Proceedings of the KTCVS Conference
• /
• 1995.10a
• /
• pp.71-71
• /
• 1995

• Journal of Chest Surgery
• /
• v.34 no.5
• /
• pp.414-417
• /
• 2001

흉부 대동맥의 비 외상성 자연 파열은 매우 드물지만, 발생시 응급수술이 요하는 위중한 질환이다. 본원에서는 전산화 단층 촬영과 경식도 초음파로 진단하고 부분 대동맥궁 치환술로 성공적으로 치료된 후 흉부 대동맥의 비 외상성 지연 파열 1례를 체험하였기에 문헌고찰과 더불어 보고하는 바이다.

• Proceedings of the KTCVS Conference
• /
• 1993.06a
• /
• pp.53-53
• /
• 1993

• Journal of the Korean Society of Radiology
• /
• v.83 no.1
• /
• pp.28-41
• /
• 2022

Acute coronary syndrome involves three types of coronary artery disease associated with sudden rupture of coronary artery plaque, and has a clinical presentation ranging from ST-segment elevation myocardial infarction (STEMI) to non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina. Cardiac CT can help quantify and characterize atherosclerotic plaques. According to a previous study, low-attenuation plaque, napkin ring sign, positive remodeling, spotty calcification, and increased perivascular fat attenuation are associated with plaque ruptures on cardiac CT. Therefore, coronary artery stenosis, as well as acute coronary artery syndrome, can be diagnosed using cardiac CT.