TRAUMATIC RUPTURE OF THE PERICARDIUM WITH A PECULIAR CHEST RADIOGRAPHIC FINDING

A 46-year-old man was admitted because of progressive exertional dyspn ea and pulsating neck vein for 3 years. He had a history of car accide nt with his chest struck by the steering wheel 10 years previously. Ph ysical checkup and laboratory studies revealed severe tricuspid regurg itation. The chest radiography disclosed mild cardiomegaly and shift o f the heart towards the left hemithorax with a bizarre cardiac silhoue tte showing double contour over the left ventricular border, suggestin g the possibility of partial absence of the left pericardium. The latt er diagnosis was confirmed at open heart surgery for the associated se vere tricuspid regurgitation.