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Are anticoagulated patients with isolated sternal fractures at risk of pericardial tamponade?

Michael Joseph Monteiro, Richard Downing

CaseRepClinPractRev 2005; 6:118-120

ID: 428831

Background: The incidence of sternal fractures has increased threefold since the introduction of seatbelt legislation in the UK in 1983. Isolated sternal fractures usually occur in association with seatbelt restrained injuries, predominantly in the elderly. As anticoagulants are often indicated in the elderly, they are therefore at increased risk of haemorrhagic complications following sternal fracture.Case Report: The risk of cardiac tamponade in anticoagulated patients with isolated sternal fractures following road traffic accidents has not been discussed previously. Three cases are described to highlight the clinical assessment and investigation of suspected cardiac tamponade in anticoagulated patients following sternal fracture.Conclusions: The risk of pericardial tamponade is presumed to increase in anticoagulated patients following sternal fracture. A range of investigations including ECG, cardiac enzyme assay, echocardiography, and CT scanning may be performed to confirm or exclude this life-threatening condition if suspected.

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