A Case of Cardiac Laceration due to Anterior Thoracic Stab Injury

흉부 자상 환자에서 발생한 심장 열상

  • Woo, Won Gi (Department of Cardiothoracic Surgery, Yonsei University College of Medicine) ;
  • Jang, Ji Young (Department of Surgery, Yonsei University College of Medicine) ;
  • Lee, Seung Hwan (Department of Surgery, Yonsei University College of Medicine) ;
  • Lee, Chang Young (Department of Cardiothoracic Surgery, Yonsei University College of Medicine) ;
  • Lee, Jae Gil (Department of Surgery, Yonsei University College of Medicine)
  • 우원기 (연세대학교 의과대학 흉부외과학교실) ;
  • 장지영 (연세대학교 의과대학 외과학교실) ;
  • 이승환 (연세대학교 의과대학 외과학교실) ;
  • 이창영 (연세대학교 의과대학 흉부외과학교실) ;
  • 이재길 (연세대학교 의과대학 외과학교실)
  • Received : 2013.12.13
  • Accepted : 2014.07.08
  • Published : 2014.09.30

Abstract

Among chest trauma patients, cardiac laceration is a rare, but severe, condition requiring prompt management. Depending on the patient's hemodynamic status, early detection rate of a cardiac laceration may or may not be occur. If a possibility of cardiac laceration exists, an emergent thoracotomy should be performed. Furthermore, patients who experience a cardiac laceration also experience different kinds of complications. Therefore, close follow-up and monitoring are required. Herein, we report a 41-year-old man with a left atrium and a left ventricle laceration caused by a thoracic stab injury.

Keywords

References

  1. Campbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. Review of 1198 cases of penetrating cardiac trauma. Br J Surg 1997; 84: 1737-40. https://doi.org/10.1002/bjs.1800841225
  2. Asensio JA, Soto SN, Forno W, Roldan G, Petrone P, Gambaro E, et al. Penetrating cardiac injuries: a complex challenge. Surg Today 2001; 31: 1041-53. https://doi.org/10.1007/s595-001-8055-0
  3. Robbs JV, Baker LW. Cardiovascular trauma. Curr Probl Surg 1984; 21: 1-87.
  4. Gwely NN, Mowafy A, Khalaf S, Amer S, Hamza U, El- Saeed M. Management of stab wounds of the heart: analysis of 73 cases in 10 years. Thorac Cardiovasc Surg 2010; 58: 210-4. https://doi.org/10.1055/s-0029-1240921
  5. Karin E, Greenberg R, Avital S, Aladgem D, Kluger Y. The management of stab wounds to the heart with laceration of the left anterior descending coronary artery. Eur J Emerg Med 2001; 8: 321-3. https://doi.org/10.1097/00063110-200112000-00014
  6. Nagy KK, Lohmann C, Kim DO, Barrett J. Role of echocardiography in the diagnosis of occult penetrating cardiac injury. J Trauma 1995; 38: 859-62. https://doi.org/10.1097/00005373-199506000-00004
  7. Jimenez E, Martin M, Krukenkamp I, Barrett J. Subxiphoid pericardiotomy versus echocardiography: a prospective evaluation of the diagnosis of occult penetrating cardiac injury. Surgery 1990; 108: 676-9.
  8. Meyer DM, Jessen ME, Grayburn PA. Use of echocardiography to detect occult cardiac injury after penetrating thoracic trauma: a prospective study. J Trauma 1995; 39: 902-7. https://doi.org/10.1097/00005373-199511000-00014
  9. Plurad DS, Bricker S, Van Natta TL, Neville A, Kim D, Bongard F, et al. Penetrating cardiac injury and the significance of chest computed tomography findings. Emerg Radiol 2013; 20: 279-84. https://doi.org/10.1007/s10140-013-1113-0
  10. Tang AL, Inaba K, Branco BC, Oliver M, Bukur M, Salim A, et al. Postdischarge complications after penetrating cardiac injury: a survivable injury with a high postdischarge complication rate. Arch Surg 2011; 146: 1061-6. https://doi.org/10.1001/archsurg.2011.226
  11. Buchman TG, Phillips J, Menker JB. Recognition, resuscitation and management of patients with penetrating cardiac injuries. Surg Gynecol Obstet 1992; 174: 205-10.
  12. DuBose RA, Karmy-Jones R. Delayed diagnosis and management of an "occult" stab wound to the heart. Am Surg 2005; 71: 879-81.
  13. Castano W, Morales CH, Senior JM, Benjumea WY, Sanchez J. Relationship of echocardiographic and coronary angiographic findings in patients with acute myocardial infarction secondary to penetrating cardiac trauma. J Trauma Acute Care Surg 2012; 73: 111-6. https://doi.org/10.1097/TA.0b013e318256a0d8