CTICasesPost-CPR Left Atrial Injury
Imaging findings
CT angiography shows a large mediastinal hematoma compressing the left atrium and pulmonary veins, with active contrast extravasation tracking along the pulmonary veins. The patient has multiple rib and pubic fractures from a fall and underwent chest compressions during CPR.
Key takeaways
Vigorous chest compressions during CPR can cause severe iatrogenic thoracic injuries, including rib fractures, pneumothorax, and cardiac/atrial lacerations. Left atrial or pulmonary vein injury should be suspected when a rapidly expanding mediastinal hematoma is seen compressing cardiac structures.
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