Trauma cardíaco fatal na cidade de Manaus/AM, Brasil.

Araújo, Antônio Oliveira de; Westphal, Fernando Luíz; Lima, Luiz Carlos de Oliveira; Correia, Jéssica de Oliveira; GOMES, PEDRO HENRIQUE DA SILVA; Costa, Emanoel Nascimento; Salomão, Luciana Macedo Level; Costa, Cleinaldo Nascimento

doi:10.1590/0100-6991e-20181888

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…The surgeon needs a high degree of suspicion in cases that present themselves with stable hemodynamics, otherwise a fraction of these patients can rapidly die due to delay in the diagnosis of cardiac injury 4,5 . Some authors have demonstrated less invasive diagnostic evaluation through videothoracoscopy and even advocated conservative treatment in patients stable in specialized surgical services 6 .…”

Section: Discussionmentioning

confidence: 99%

Hemopericardio por disparo sin lesión cardíaca, descripción de un mecanismo de trauma

2020

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Introducción. Durante muchos siglos, las heridas del corazón se consideraron fatales. Actualmente, el trauma cardíaco sigue siendo una de las lesiones más letales. Los resultados de pacientes con lesión cardíaca penetrante pueden variar de lesiones letales a arritmias que se resuelven espontáneamente. El hemopericardio en el trauma generalmente es debido a la lesión cardíaca penetrante, pero el saco pericárdico puede llenarse de sangre de grandes vasos y de la ruptura de la arteria pericardiofrénica asociada a laceración pericárdica contusa. Métodos. Para la organización de este estudio, se realizó una búsqueda bibliográfica en la literatura científica. Dos casos fueron observados por el equipo de Cirugía General al describir este raro mecanismo de trauma. Resultados. Descripción de una causa diferente de hemopericardio, ocasionada por la sangre de la cavidad peritoneal. Discusión. En los casos presentados, la lesión por arma de fuego rompió la barrera entre las cavidades pericárdica y peritoneal (diafragma), colocando cavidades con diferentes niveles de presión, favoreciendo la entrada de sangre de la cavidad peritoneal al saco pericárdico. Conclusión. En los casos observados el proyectil pasó muy cerca del corazón, pero sin lesionarlo. La ruptura de la superficie diafragmática del pericardio permitió que la presión de la cavidad peritoneal se igualara con la presión del pericardio.

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Section: Discussionmentioning

confidence: 99%

Hemopericardio por disparo sin lesión cardíaca, descripción de un mecanismo de trauma

2020

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“…The involvement of multiple chambers or great vessels has also been associated with higher mortality (Tyburski et al, 2000;Morse et al, 2016) The etiology of the PCI plays a fundamental role, as GSW has worse prognosis than SW. (Kaljusto et al, 2015) Even though the injury is in a principal organ, the causes of death are not usually directly related to the injury itself, but due to the complications that may develop afterwards, such as cardiac tamponade or exsanguination which lead to hypovolemic shock. (Kang et al, 2009;Karigyo Toshiyuki et al, 2013;Kaljusto et al, 2015;de Araújo et al, 2018) Cardiac tamponade is a feared complication of a penetrating cardiac injury as it is the main cause of death on these patients. It could lead to subendocardial ischemia, malignant arrhythmias or cardiac arrest.…”

Section: Prognosismentioning

confidence: 99%

“…(Nummela et al, 2019) SW are the most prevalent cause of surgical intervention of PCI (39-81.4%) (Uchimura et al, 2010;Karigyo Toshiyuki et al, 2013;Besir, Gokalp and Eygi, 2015;Khorsandi et al, 2015), even though GSW has been reported as the main etiology of PCI, it often presents higher mortality rate prior to the arrival into the OR. (Albadani and Alabsi, 2013;Kaljusto et al, 2015;Melo et al, 2017;de Araújo et al, 2018)…”

Section: Prognosismentioning

confidence: 99%

Solving the impossible. Penetrating cardiac injuries, a case series of diagnostic workup and management

Vergara-Miranda

Álvarez-Lozada

Leyva-Alamillo

et al. 2021

IJMSS

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For a long time, any heart-based injury was an off-limits area for surgeons; a patient with a traumatic cardiac injury was doomed to die. Little more than one hundred years have passed since the first surgical correction of a penetrating cardiac injury and there is still a high rate of mortality, despite the medical advances. We present the case of 6 patients with penetrating cardiac injuries that were repaired at a third level hospital of Mexico, alongside relevant findings on the literature about the topic. From 2019 to 2020, an incidence of 6 patients with penetrating cardiac injuries was present; all men aged 30 years or older. The etiology of 4 (67%) patients was stab wounds and 2 (33%) gunshot wounds. Left anterolateral thoracotomy was used on 5 (83%) patients and midline sternotomy on 1 (17%) patient. 2 (33%) injuries on the left ventricle presented along with coronary arteries injuries. Left ventricle and right atrium injuries presented each 50% of mortality. The mortality was of 33%, 1 patient died due to intraoperative complications and another one due to massive cerebral infarction and polyuric syndrome because of diabetes insipidus. There is a long path ahead of the surgical field on this topic and further to be analyzed. An excellent tool for cardiac tamponade diagnosis due to penetrating cardiac injuries is cardiac ultrasound, therefore it should be used on every hemodynamic unstable patient in the context of PCI. Definitively, time is of the essence, and the survival of patients depends on immediate transport to a hospital and an opportune surgical intervention.

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“…Presently, improvement on the pre-hospital and hospital care increase the survival rate of patients with penetrating heart injuries, allowing for a greater possibility of exams and diagnostic procedures and continued improvement in treatment [2][3][4][5] .…”

mentioning

confidence: 99%

“…Due to its anatomical position, the right ventricle, which accounts for most of the anterior surface of the heart (sternocostal), is classically described as the most vulnerable cardiac chamber, and death occurs mainly due to hypovolemic shock and to cardiac tamponade. A penetrating heart injury requires a precise diagnosis and immediate treatment 2,3,6 .…”

mentioning

confidence: 99%

O uso da tomografia computadorizada na triagem da lesão cardíaca penetrante.

Góes

Oliveira

Albuquerque

et al. 2019

Rev. Col. Bras. Cir.

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RESUMO Objetivo: determinar se a tomografia computadorizada representa uma opção segura para triagem de lesões cardíacas penetrantes. Métodos: estudo transversal retrospectivo, que confrontou os achados tomográficos com os detectados na exploração cirúrgica em pacientes operados por suspeita de trauma cardíaco no período de janeiro de 2016 a janeiro de 2018. Resultados: setenta e dois casos foram analisados; 97,2% eram do sexo masculino e a faixa etária mais prevalente foi de 20 a 29 anos; 56,9% apresentaram ferimentos por projéteis de arma de fogo e 43,1% por arma branca. Em 20 casos, a tomografia computadorizada foi sugestiva de lesão cardíaca, confirmada em 13 casos durante a cirurgia. A sensibilidade da tomografia computadorizada foi de 56,5% e a especificidade de 85,7%. Conclusão: a tomografia computadorizada não deve ser adotada rotineiramente para triagem de ferimentos cardíacos penetrantes.

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Trauma cardíaco fatal na cidade de Manaus/AM, Brasil.

Cited by 11 publications

References 25 publications

Hemopericardio por disparo sin lesión cardíaca, descripción de un mecanismo de trauma

Hemopericardio por disparo sin lesión cardíaca, descripción de un mecanismo de trauma

Solving the impossible. Penetrating cardiac injuries, a case series of diagnostic workup and management

O uso da tomografia computadorizada na triagem da lesão cardíaca penetrante.

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