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Penetrating cardiac injuries of the left ventricle – a case series and review of literature

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Title: Penetrating cardiac injuries of the left ventricle – a case series and review of literature
Authors: Rudo Pswarayi, Devorah Wineberg, Anna Kerola
Contributors: HUS Musculoskeletal and Plastic Surgery
Source: Annals of Medicine & Surgery. 87:4039-4045
Publisher Information: Ovid Technologies (Wolters Kluwer Health), 2025.
Publication Year: 2025
Subject Terms: Resuscitation, Vascular, Case report, Surgery, anesthesiology, intensive care, radiology, Cardiothoracic, Trauma
Description: Background: Penetrating cardiac injuries (PCIs) remain a significant surgical challenge, characterized by high mortality rates, particularly in young adult males. The mechanism of injury (gunshot wound vs. stab wound) significantly influences outcomes. Importance: This study presents two cases of left ventricle PCIs, emphasizing the need for prompt diagnosis and intervention. The rising incidence of PCI necessitates a high index of suspicion based on clinical findings and basic imaging to facilitate timely surgical intervention and potentially improve survival. Case series: Two patients presented within 48 hours at a South African hospital. Case 1 involved a 32-year-old male with a stab wound to the anterior left ventricle, injuring the left anterior descending artery. Case 2 involved a 26-year-old male with a gunshot wound (GSW) to the posterior left ventricle. Both underwent immediate surgical repair. Discussion: The clinical presentations, diagnostic approaches (including eFAST), and operative techniques are described. Postoperative courses varied significantly; one patient developed complications including severe hypertension and Takotsubo cardiomyopathy, while the other had an uncomplicated recovery. A literature review highlights inconsistencies in reported PCI incidence and mortality, largely attributed to small sample sizes and methodological limitations in previous studies. Conclusion: The increased frequency of GSWs and stab wounds causing PCIs underscores the importance of a high index of suspicion supported by clinical findings and basic imaging to enable rapid surgical intervention. This expeditious approach could potentially improve mortality rates. Further research with larger, well-designed studies is crucial to refine our understanding of PCI management and improve outcomes.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 2049-0801
DOI: 10.1097/ms9.0000000000003402
Access URL: http://hdl.handle.net/10138/599067
Rights: CC BY NC ND
Accession Number: edsair.doi.dedup.....334c6e2b8bcf4f4c5c279519c57fb746
Database: OpenAIRE
Description
Abstract:Background: Penetrating cardiac injuries (PCIs) remain a significant surgical challenge, characterized by high mortality rates, particularly in young adult males. The mechanism of injury (gunshot wound vs. stab wound) significantly influences outcomes. Importance: This study presents two cases of left ventricle PCIs, emphasizing the need for prompt diagnosis and intervention. The rising incidence of PCI necessitates a high index of suspicion based on clinical findings and basic imaging to facilitate timely surgical intervention and potentially improve survival. Case series: Two patients presented within 48 hours at a South African hospital. Case 1 involved a 32-year-old male with a stab wound to the anterior left ventricle, injuring the left anterior descending artery. Case 2 involved a 26-year-old male with a gunshot wound (GSW) to the posterior left ventricle. Both underwent immediate surgical repair. Discussion: The clinical presentations, diagnostic approaches (including eFAST), and operative techniques are described. Postoperative courses varied significantly; one patient developed complications including severe hypertension and Takotsubo cardiomyopathy, while the other had an uncomplicated recovery. A literature review highlights inconsistencies in reported PCI incidence and mortality, largely attributed to small sample sizes and methodological limitations in previous studies. Conclusion: The increased frequency of GSWs and stab wounds causing PCIs underscores the importance of a high index of suspicion supported by clinical findings and basic imaging to enable rapid surgical intervention. This expeditious approach could potentially improve mortality rates. Further research with larger, well-designed studies is crucial to refine our understanding of PCI management and improve outcomes.
ISSN:20490801
DOI:10.1097/ms9.0000000000003402