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Thanks for sharing for our learning. Crazy case. My guess is the negative FAST suggests he blew out the left ventricle probably between FAST and CT since you most likely would have seen fluid (blood) in the left hemithorax on your LUQ view. The vitals correlate too.
For those 18Ds interested in ultrasound- this is why serial FAST exams are so important especially if your trauma patient's clinical status changes. In this case Eagle knew there was a problem in the left chest and put in a diagnostic/therapeutic chest tube, but in a forward location or MASCAL without CT available the bedside serial E-FAST is your friend.
Keep 'em coming Doc!
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