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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107

Abstract

MEDRANO-PLANA, Yuri; QUINTANA-SOUZA, Rider; BARRUETO-BLANCO, Yarisley  and  ZAMBRANO-CEVALLOS, Katherine Margarita. Missed cardiac stab injury during initial evaluation in the Emergency Department. rev. colomb. cir. [online]. 2024, vol.39, n.1, pp.148-154.  Epub July 27, 2023. ISSN 2011-7582.  https://doi.org/10.30944/20117582.2330.

Introduction.

The reported incidence of cardiac trauma is low and its degree of resolution is variable depending on the cause, the mechanism of injury, the place where it occurs and the characteristics of the health care system. Their incidence has currently increased due to the increase in traffic accidents and violence, with a predominance of penetrating trauma associated with stab wounds and firearms. Cardiac trauma is accompanied by a high degree of lethality.

Clinical case.

A 35-year-old female patient, evaluated in the emergency room for penetrating thoracic trauma caused by stab wound. She underwent emergency intervention due to left pleural effusion, but without hemodynamic improvement. She was reevaluated and pericardial effusion with cardiac tamponade caused by cardiac injury was detected. She was treated surgically with satisfactory results.

Results.

The clinical manifestations generally described in penetrating cardiac trauma are severe and fatal, but in some cases and due to the characteristics of the injury caused, the patient’s hemodynamics may not be so compromised. To consolidate the clinical diagnosis, several complementary studies can be performed, with FAST ultrasound being one of the most recommended due to its high sensitivity and specificity. Surgical treatment is still the most indicated, depending on the technological progress of the hospital and the hemodynamic stability of the patient.

Conclusions.

Knowledge of penetrating cardiac trauma is of great importance, not only for the emergency department physician but also for the general practitioner. A quick and accurate diagnosis, together with adequate management can be decisive in saving the patient’s life.

Keywords : wounds and injuries; penetrating wounds; heart injuries; cardiac tamponade; thoracic surgery.

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