PMC3567954_01
A young mother with pectus excavatum holding her two-year-old boy in her arms during the car accident. Caudal view.
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F1
A 43-year-old Caucasian German woman wearing a three-point seatbelt and holding her two-year-old boy in her arms in the front passenger seat of a car was involved in a head-on collision with a tree (Figure 1).
Computed tomography scan showing the three-cm pericardial effusion.
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F2
Trauma did not detect any free intraperitoneal fluid. The initial radiological assessment (chest, pelvic and cervical spine X-ray) showed the clinically evident pectus excavatum, multiple rib fractures and a stable, not dislocated, pelvic fracture. Fifteen minutes after admission she was transported alert and in a cardiopulmonary stable state to the computed tomography (CT) scanner. The CT scan demonstrated a zygomatic fracture, three-cm pericardial effusion (Figure 2), fractures of the 2nd and 3rd ribs, and a pelvic type C fracture. 
Intraoperative photo of the one-cm left atrial laceration.
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F3
Intraoperatively, a combined one-cm laceration of the left atrium and right ventricle was noted (Figure 3).