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Non-lethal penetrating cardiac injury from a crossbow bolt

K Besler1, M Kleiber, H R Zerkowski

  • 1Institut für Rechtsmedizin, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany.

Insights

A rare crossbow injury to the heart, caused by a suicide attempt, highlights the critical role of arrowhead type in thoracic trauma outcomes. Despite a deep myocardial lesion and diagnostic delays, the patient survived this severe chest trauma.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Forensic Pathology

Background:

  • Thoracic injuries from crossbows are infrequent in modern medicine.
  • Arrowhead characteristics significantly influence wound presentation and patient prognosis.
  • Understanding rare penetrating cardiac injuries is crucial for emergency response.

Observation:

  • A 38-year-old male presented after a suicide attempt involving a self-inflicted sport crossbow injury.
  • The crossbow bolt traversed the mediastinum, creating a deep intraseptal myocardial lesion.
  • Diagnostic procedures preceded surgical intervention, introducing a delay in treatment.

Findings:

  • Despite the severity of the myocardial injury and delayed operation, the patient demonstrated survival.
  • The case underscores the potential for survival even with deep cardiac penetration.
  • The specific type of arrowhead and its trajectory were critical factors.

Implications:

  • This case provides valuable insights into the management of rare, high-energy penetrating cardiac trauma.
  • It emphasizes the importance of rapid assessment and intervention in severe thoracic injuries.
  • Findings contribute to the literature on survivability of self-inflicted cardiac impalement injuries.

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