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Published on: November 4, 2015
[Penetrating foreign body in the left ventricle with undetected chronic evolution]
Francisco L Moreno-Martínez1, Alvaro L Lagomasino Hidalgo, Jean L Chao García
1Unidad de Hemodinámica y Cardiología Intervencionista, Cardiocentro Ernesto Che Guevara, Villa Clara, Cuba. flmorenom@yahoo.com
Insights
This case study highlights a rare instance of a patient surviving with a copper wire fragment lodged in their heart for over three months. The foreign body traversed multiple heart chambers without causing significant bleeding, a unique finding in penetrating cardiac trauma.
Area of Science:
- Cardiology
- Trauma Surgery
- Medical Case Reports
Background:
- Penetrating cardiac trauma is life-threatening, with high mortality rates.
- Metallic foreign bodies, often from firearms, are common causes.
- Accidental and inadvertent cardiac penetrations are rare.
Observation:
- A patient presented with a penetrating cardiac injury from a copper wire fragment after closed-chest trauma.
- The foreign body lodged in the left ventricle for over three months.
- It traversed the right ventricle, interventricular septum, and mitral valve apparatus.
Findings:
- This is the only reported case of a foreign body crossing multiple cardiac structures.
- The fragment occupied a significant portion of the heart's anteroposterior diameter.
- Remarkably, no acute or chronic bleeding occurred.
Implications:
- This case challenges typical outcomes for penetrating cardiac trauma.
- It underscores the possibility of asymptomatic foreign body retention in the heart.
- Further research into the mechanisms of tolerance and management strategies for such rare injuries is warranted.
Abstract:
Penetrating cardiac trauma constitutes a serious threat for life. Less than the third part of all patients who suffer it arrives at the hospital alive, and half of them die. Most of the penetrating foreign bodies in the heart are metallic, and are frequently caused by firearms and rarely by self-injury. The accidental penetration is uncommon but inadvertent penetration is extremely rare. We present the case of a patient who suffered a closed-chest trauma and did not notice the penetration of a foreign body (copper wire fragment) in the heart. It remained lodged in the left ventricle for more than 3 months. This it is the only case reported in the literature where a strange body: a) crosses the free wall of the right ventricle, the right ventricular cavity, interventricular septum, and the mitral valve apparatus; b) occupies almost all the anteroposterior diameter of the heart, and c) did not produce acute or chronic bleeding.
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