Penetrating Injuries of the Heart

Δημητριάδης, Δημήτριος; Veen, B W van der

doi:10.1097/00005373-198312000-00003

Cited by 154 publications

(9 citation statements)

References 1 publication

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“…Of the subjects that reach the hospital, 80% have hemodynamic instability requiring urgent median sternotomy or thoracotomy [8]. In our study, 5 of the patients who reached the hospital had hemodynamic instability requiring emergency operations.…”

Section: Discussionmentioning

confidence: 70%

Hemopericardium-Related Fatalities: A 10-Year Medicolegal Autopsy Experience

Altun¹,

Altun

Yılmaz³

2005

Cardiology

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Background: Patients with blunt or penetrating cardiac injury usually present with cardiac tamponade and hemorrhagic shock upon hospital arrival. Many victims die before they reach hospital. In this study, we present a detailed analysis of hemopericardium-related fatalities. Methods: We retrospectively reviewed the medicolegal autopsy records of hemopericardium-related fatalities that occurred from 1994 to 2003. The parameters investigated were demographic characteristics, hospitalization before death, the cause of death, the manner of death, the mechanism of death, the location of the entrance wound, the number of wounds reaching the target and the site of target perforation. Results: Seven women (mean age: 45 ± 23 years) and 33 men (mean age: 34 ± 12 years) were included in the study. Only 5 patients (12.5%) with cardiac activity reached the hospital. Twenty individuals (50%) were victims of stabbings, which was the most common cause of death. The most commonly encountered manner of death was homicide (79%). Thirty-one (77.5%) victims died of hemorrhagic shock and 9 (22.5%) of cardiac tamponade. Entrance wounds were frequently located on the left chest (n = 26). The perforated cardiac chambers were the left atrium (n = 1), the left ventricle (n = 12), the right atrium (n = 2) and the right ventricle (n = 15). One victim had coronary artery perforation. Nine victims had perforations on the intrapericardial part of the aorta. Conclusions: In our series, the hemopericardium-related deaths occurred predominantly in men. Stabbing was the most common cause of death. Entrance wounds were most commonly located on the left chest, and perforated sites were ventricles. Death at the scene was also frequent, and the mechanism of death was hemorrhagic shock.

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Section: Discussionmentioning

confidence: 70%

Hemopericardium-Related Fatalities: A 10-Year Medicolegal Autopsy Experience

Altun¹,

Altun

Yılmaz³

2005

Cardiology

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“…In our patient, LAD was damaged by a stab wound. A retrospective study of 532 autopsy reports revealed that LAD is the most affected artery (7), which leads to death in most cases, and therefore few articles are available on it. Most of those who survive, often survive through emergency thoracotomy and ligation of the injured artery (2).…”

Section: Discussionmentioning

confidence: 99%

Benefits of delayed revascularization following ligation of anterior descending artery after a stab wound

et al. 2022

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Penetrating cardiac trauma often results in death. However, in rare cases when patients survive, there is almost always a need for damage control by artery ligation. Following that, revascularization is recommended as soon as possible. The extent to which revascularization is effective has not yet been studied and agreed upon. A 24-year-old man with a penetrating stab wound to the heart and left anterior descending (LAD) artery received primary life-saving treatment with artery ligation and was then referred for revascularization. Nonetheless, the patient did not consent to coronary artery bypass grafting (CABG) and was discharged against medical advice with ejection fraction (EF) of 20%. He returned three months later due to chest pain and heart failure, then underwent revascularization which increased the patient’s EF to 45% and significantly improved the symptoms. Although CABG revascularization is recommended as soon as possible after main coronary arteries are ligated, our patient showed that such patients benefit from delayed revascularization surgery and that they should not be deprived of its benefits only because of the long time passed.

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“…Coronary artery injury is rare with some reports citing an incidence of 3.1-4.4% of penetrating cardiac injury [2, 4, 16] and often requires surgical or interventional treatment. LAD is the most frequently involved vessel followed by RCA [2, 17].…”

Section: Discussionmentioning

confidence: 99%

“…Penetrating cardiac injuries are highly lethal and carry high mortality rate that can be as high as 80 % [1]. Both blunt and penetrating cardiac injuries, in patients who survive, are known to present with well-known sequelae that often appear days to weeks after the initial insult [2-4]. In the literature there have been documented cases of cardiac injury induced myocardial infarction, ventricular aneurysms, valvular dysfunction and even fistulous tracts between the coronary vessels and chamber [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Post Traumatic Pseudoaneurysm of Left Anterior Descending Artery Presenting as Acute Coronary Syndrome

et al. 2019

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Penetrating cardiac injuries are highly lethal and carry high mortality rate. Both blunt and penetrating cardiac injuries in patients who survive are known to present with well-known sequelae that often appear days to weeks after the initial insult. In the literature there have been documented cases of cardiac injury induced myocardial infarction, ventricular aneurysms, valvular dysfunction and even fistulous tracts between the coronary vessels and chamber. Although the most commonly injured vessel is the left anterior descending (LAD) coronary artery, traumatic injuries to the left coronary artery result in early death in the majority of cases. We present a unique case of LAD pseudo aneurysm and stenosis presenting as acute coronary syndrome (ACS) months after the initial penetrating cardiac injury successfully managed by stenting. There are only few isolated case reports of coronary artery pseudoaneurysm following penetrating chest trauma published in English literature.

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Penetrating Injuries of the Heart

Cited by 154 publications

References 1 publication

Hemopericardium-Related Fatalities: A 10-Year Medicolegal Autopsy Experience

Hemopericardium-Related Fatalities: A 10-Year Medicolegal Autopsy Experience

Benefits of delayed revascularization following ligation of anterior descending artery after a stab wound

Post Traumatic Pseudoaneurysm of Left Anterior Descending Artery Presenting as Acute Coronary Syndrome

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