RESUMO
A case of a 23 year-old man who, thanks to his parietal pericardium, scarred by previous open heart surgery, survived traumatic ventricular free wall and coronary artery rupture, without surgical repair, is reported. He was injured in a traffic accident and transferred to our hospital immediately. On arrival, he was hypotensive, with blood pressure of 53/25 mmHg. Because hemoperitoneum was suspected, an emergency exploratory laparotomy was performed. After surgery, his blood pressure stabilized, but electrocardiography showed abnormal findings that had not existed before the traffic accident. To find the probable cause of the electrocardiographic changes, echocardiography was performed, which showed a right ventricular free wall and right coronary artery ruptures. Nevertheless, he survived, without surgery, due to the thickened and adhered pericardium around the rupture site, which presumably resulted from the prior open heart surgery. Since discharged, he has remained well for nine months, with no further events.