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心脏创伤后迟发性心脏压塞-病例报告。

Late Cardiac Tamponade in a Patient Victim of Penetrating Trauma - Case Report.

机构信息

University of Amazonas State, Manaus, AM, Brazil.

Adriano Jorge Hospital Foundation, Manaus, AM, Brazil.

出版信息

Braz J Cardiovasc Surg. 2020 Dec 1;35(6):1017-1019. doi: 10.21470/1678-9741-2019-0130.

Abstract

A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit clinical management, with hospital discharge in the 7th postoperative day.

摘要

现报道 1 例 49 岁男性患者,刀刺伤后迟发性心脏压塞且血流动力学稳定。患者行心包开窗术,引流出黑色外观的心包积液;然而,由于未能观察到心脏损伤,故选择经胸骨正中切开术扩大切口。发现左心室有血肿合并心外膜损伤,用 3-0 聚丙稀修补心包。患者出现急性肺水肿和心房颤动,经重症监护病房临床治疗后改善,术后第 7 天出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/337f/7731853/5fab90d96dec/rbccv-35-06-1017-g01.jpg

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本文引用的文献

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Fatal cardiac trauma in the city of Manaus, Amazonas state, Brazil.
Rev Col Bras Cir. 2018 Oct 4;45(4):e1888. doi: 10.1590/0100-6991e-20181888.
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Selective use of pericardial window and drainage as sole treatment for hemopericardium from penetrating chest trauma.
Trauma Surg Acute Care Open. 2018 Aug 30;3(1):e000187. doi: 10.1136/tsaco-2018-000187. eCollection 2018.
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Delayed Tamponade after Traumatic Wound with Left Ventricular Compression.
Case Rep Cardiol. 2016;2016:2154748. doi: 10.1155/2016/2154748. Epub 2016 Aug 29.

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