Struck by Cupid's arrow: penetrating chest trauma

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Emergency Medicine

Background:

• Penetrating cardiac injuries are a significant cause of mortality.
• Hemorrhage and trauma coagulopathy are primary concerns.
• Prompt management is critical for survival.

Observation:

• A 50-year-old male sustained a severe penetrating cardiac injury from an iron bar.
• The impalement involved passage through the right hilum, left atrium, and right ventricle.
• The patient presented 6 hours post-injury with stable vital signs.

Findings:

• Surgical removal of the impaling iron bar was performed.
• The procedure was successfully completed without the need for cardiopulmonary bypass.
• Minimal blood loss was reported during the surgical intervention.

Implications:

• This case highlights the feasibility of managing complex penetrating cardiac injuries without cardiopulmonary bypass.
• It underscores the importance of timely surgical intervention in severe trauma cases.
• The successful outcome suggests potential for improved survival rates in similar critical injuries.