Right atrial rupture secondary to blunt trauma is exceedingly rare. We present a case report of blunt chest trauma and right atrial rupture in a patient with a background of pericardiectomy that were successfully managed surgically. Right atrial rupture must be considered as a differential diagnosis in patients with blunt chest trauma. In patients with previous pericardiectomy, this injury may manifest with massive hemothorax, and insertion of a chest drain should be performed with extreme caution. In our experience, urgent exploratory thoracotomy and repair of the defect are the mainstays of acute management.
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