Citation

Connelly TM, Kolcow W, Veerasingam D, DaCosta M. Interact. Cardiovasc. Thorac Surg. 2016; 24(2): 286-287.

Affiliation

Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland.

Copyright

(Copyright © 2016, European Association for Cardio-Thoracic Surgery)

DOI

10.1093/icvts/ivw342

PMID

27789730

Abstract

Penetrating cardiac injury is rare and frequently not survivable. Significant haemorrhage resulting in cardiac tamponade commonly ensues. Such cardiac tamponade is a clear clinical, radiological and sonographic indicator of significant underlying injury. In the absence of cardiac tamponade, diagnosis can be more challenging. In this case of a 26-year old sailor stabbed at sea, a significant pericardial effusion and cardiac tamponade did not occur despite an injury transversing the pericardium. Instead, the pericardial haemorrhage drained into the left pleural cavity resulting in a haemothorax. This case is notable due to a favourable outcome despite a delay in diagnosis due to a lack of pericardial effusion, a concomitant cerebrovascular event and a long delay from injury to appropriate medical treatment in the presence of a penetrating cardiac wound deep enough to cause a muscular ventricular septal defect and lacerate a primary chordae of the anterior mitral leaflet.

© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Language: en