Rastogi Ashok Kumar, Kumar Tarun, Patil Amit, Kumar Binay
Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Patna, IND.
Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND.
Cureus. 2023 Jan 12;15(1):e33716. doi: 10.7759/cureus.33716. eCollection 2023 Jan.
Though uncommon, puncture injury to the heart can occur during cardiac resuscitation and when inserting a lifesaving drug directly into the left ventricle of the heart. Utmost precaution must be taken to avoid damaging the conduction system of the heart, particularly the nodal part, as it can cause cardiogenic shock, arrhythmia, and sudden death. Our index case report describes a 55-year-old male who was fatally injured after being hit by a truck while riding his bike. The autopsy revealed multiple puncture injuries to the atrioventricular node area of the septum, observed on both sides of the interatrial septal wall surface. Histopathological examination also showed subendocardial hemorrhage around the atrioventricular nodal area. The nature of the injuries made identification of the cause of death difficult.
虽然罕见，但心脏穿刺伤可发生在心脏复苏期间以及将救命药物直接注入心脏左心室时。必须采取最大程度的预防措施以避免损害心脏的传导系统，尤其是节点部分，因为这可能导致心源性休克、心律失常和猝死。我们的索引病例报告描述了一名55岁男性，他骑自行车时被卡车撞到后受致命伤。尸检显示在房间隔壁表面两侧观察到间隔房室结区域有多处穿刺伤。组织病理学检查还显示房室结区域周围的心内膜下出血。损伤的性质使得确定死因变得困难。
