Work

Penetrating cardiac injuries of the left ventricle – a case series and review of literature

Year: 2025

Type: article

Abstract: Background: Penetrating cardiac injuries (PCIs) remain a significant surgical challenge, characterized by high mortality rates, particularly in young adult males. The mechanism of injury (gunshot wound vs. stab wound) significantly influences outcomes. Importance: This study presents two cases of left ventricle PCIs, emphasizing the need for prompt diagnosis and intervention. The rising incidence of PCI necessitates a high index of suspicion based on clinical findings and basic imaging to facilitate timely surgical intervention and potentially improve survival. Case series: Two patients presented within 48 hours at a South African hospital. Case 1 involved a 32-year-old male with a stab wound to the anterior left ventricle, injuring the left anterior descending artery. Case 2 involved a 26-year-old male with a gunshot wound (GSW) to the posterior left ventricle. Both underwent immediate surgical repair. Discussion: The clinical presentations, diagnostic approaches (including eFAST), and operative techniques are described. Postoperative courses varied significantly; one patient developed complications including severe hypertension and Takotsubo cardiomyopathy, while the other had an uncomplicated recovery. A literature review highlights inconsistencies in reported PCI incidence and mortality, largely attributed to small sample sizes and methodological limitations in previous studies. Conclusion: The increased frequency of GSWs and stab wounds causing PCIs underscores the importance of a high index of suspicion supported by clinical findings and basic imaging to enable rapid surgical intervention. This expeditious approach could potentially improve mortality rates. Further research with larger, well-designed studies is crucial to refine our understanding of PCI management and improve outcomes.

Source: Annals of Medicine and Surgery

DOI: 10.1097/ms9.0000000000003402

Authors: Rudo Pswarayi, Devorah Wineberg, Anna Kerola

Institutions: University of the Witwatersrand, Chris Hani Baragwanath Hospital, University of Helsinki, Helsinki University Hospital

Language: English

Topic: Trauma Management and Diagnosis

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,850