Penetrating apex cardiac trauma

ABSTRACT

Penetrating cardiac trauma is a medical emergency and should be managed as soon as possible. There are some different causes of cardiothoracic injury, which gun and stab wounds are the most important direct cause of penetrating cardiac trauma. Depending on the wound size, penetrating cardiac trauma causes different clinical manifestations. Small stab wounds lead to cardiac tamponade, meanwhile severe hemorrhage and shock are reported for gun wounds. A 45 years old man was admitted with complaints of dyspnea, weakness and severe hemorrhage during a dispute. There were two wounds on the thorax the first wound was in 5th intercostal space at left mid clavicle and the second was in 10th intercostal space at left mid axillary. Breath sounds were going to diminish in the left base. After performing CPR in emergency room, the patient was sent to operation room immediately. In operation room a left thoracotomy was performed. There was a bleeding area on apex. Apex rupture and pericardial rupture were repaired and bleeding was controlled. After 48 hours echocardiography and chest x-rays were normal and the patient was discharged in good conditions after 7 days