Penetrating cardiac trauma with cardiac exposure and right ventricle laceration due to a domestic accident: case report (Atena Editora)

Abstract

Introduction: Traumatic causes are among the main causes of morbidity and mortality in the world, especially in people under 45 years of age. This is even more visible in Brazil and Amazonas, with approximately one third of deaths in this age group occurring from traumatic etiologies. Among these, cardiac trauma presents a dramatic situation with high mortality, generally arising from violent causes or automobile accidents. We present a case of cardiac trauma resulting from a domestic accident with a plate causing right ventricle laceration and cardiac exposure. Report of case: A previously healthy 49-year-old woman was transferred to a tertiary hospital after falling over a plate, which generated a linear blunt wound measuring approximately 7cm at the level of the sixth left intercostal space, parallel to the rib, generating cardiac exposure. She had multiple emetic episodes and dyspnea, and closed chest drainage was performed upon admission, maintaining hemodynamic stability with permissive hypotension. She was approached with thoracotomy extending the wound she already had, with pericardiotomy revealing hemopericardium and a laceration in the right ventricle next to the anterior interventricular artery. After digital tamponade, a Foley catheter with traction was used to maintain hemostasis until cardiorrhaphy was performed. She was discharged after 6 days of hospitalization without any functional deficit. Conclusion: Although very uncommon, other cases of accidents with objects that can become sharp have been reported and teams in trauma centers are subject to this. We report a case with good recovery following the same principles as treatment for stab wounds.