TY - JOUR T1 - Sacré-Cœur: a torn sac JF - Emergency Medicine Journal JO - Emerg Med J SP - 651 LP - 651 DO - 10.1136/emermed-2015-204955 VL - 33 IS - 9 AU - Catalin-Iulian Efrimescu AU - Andrew Westbrook Y1 - 2016/09/01 UR - http://emj.bmj.com/content/33/9/651.abstract N2 - A 39-year-old cyclist is brought to the emergency department after being hit by a car and thrown 7 m in the air.On examination he was confused, agitated (Glasgow Coma Score 14/15) and presented with tachypnoea (RR 50), hypoxia (SpO2 75% on 15 L/min oxygen), tachycardia (heart rate 145) and hypotension (86/49 mm Hg). A focused assessment with sonography in trauma scan identified free fluid in Morrison's pouch. His chest X-ray is presented in figure 1.Figure 1 Chest X-ray after bilateral chest drain insertion.What cardiovascular complication is more likely to be the consequence of the diagnosis established on the X-ray?Aortic dissectionCardiac herniationMyocardial ruptureVentricular aneurysm … ER -