Complex gunshot injury to the heart as a consequence of suicide attempt in a schizophrenic patient

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Psychiatric Complications

Background:

• Self-inflicted gunshot wounds to the heart are rare but highly lethal, often causing cardiac tamponade or exsanguination.
• Concurrent chest or abdominal injuries can complicate management.
• This case involves a patient with schizophrenia who discontinued antipsychotic medication prior to the injury.

Purpose of the Study:

• To present the successful management of a complex self-inflicted gunshot wound to the heart.
• To highlight the critical role of rapid surgical intervention in high-mortality injuries.
• To emphasize the importance of psychiatric care in preventing such incidents.

Main Methods:

• Emergency surgical repair of cardiac and inferior vena cava injuries.
• Use of extracorporeal circulation for complex heart repair.
• Management of a hemodynamically unstable patient with hemopericardium and hemothorax.

Main Results:

• Successful repair of the heart and inferior vena cava injuries.
• Uneventful postoperative recovery.
• Patient discharged to a psychiatric facility and remains well and compliant one year post-surgery.

Conclusions:

• Complex cardiac gunshot injuries can be successfully repaired using extracorporeal circulation.
• Rapid response and transfer to a high-level trauma center are crucial for reducing mortality.
• Integrated care involving trauma surgery and psychiatric follow-up is essential for long-term patient well-being.