Discussion of Cardiac herniation
- Pericardial rupture with cardiac herniation is a rare, highly lethal injury with most patients dying before arrival at a hospital.
- Diagnosis in survivors is often delayed because initial chest radiography results are normal or show nonspecific abnormalities before cardiac herniation through the pericardial tear.
- Pericardial tears range from short and insignificant to long tears that may lead to cardiac herniation.
- Tears 8-12 cm in length are associated with cardiac herniation, 90% of which occur along the left pleuropericardium.
 Imaging Findings for Cardiac herniation
- CT has shown pericardial tears before cardiac herniation and herniation itself.
- Signs of a tear include focal pericardial discontinuity; pneumopericardium; and interposition of lung between the aorta and pulmonary artery, heart and diaphragm, or right atrium and right ventricular outflow tract— signs similar to congenital absence of the pericardium.
- The primary sign of herniation is cardiac displacement when no large pleural effusion, atelectasis, or tension pneumothorax accounts for this displacement.
- Pneumopericardium is nonspecific, but a large volume of unilateral gas within the pericardium is more diagnostic of cardiac herniation, and has been termed the empty pericardial sac.
 See Also
 External Links
 References for Cardiac herniation
- Wielenberg, Aaron J., Demos, Terrence C., Luchette, Fred A., Bova, Davide. Cardiac Herniation Due to Blunt Trauma: Early Diagnosis Facilitated by CT. Am. J. Roentgenol. 2006 187: W239-240.