Parentic Mara, Podolski Eva, Korda Marin, Katic Borna, Kajs Fran Juraj, Krzelj Kristina, Belina Drazen, Gasparovic Hrvoje, Tokic Tomislav, Duric Zeljko
University of Zagreb, School of Medicine, Zagreb 10000, Croatia.
Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb 10000, Croatia.
J Surg Case Rep. 2024 Mar 17;2024(3):rjae159. doi: 10.1093/jscr/rjae159. eCollection 2024 Mar.
Penetrating cardiac injuries are rare but are one of the most urgent emergencies because they require early intervention in order to prevent death. The mortality rate of such injuries, including pre-hospitalization deaths, goes up to 90%. The most commonly injured heart chamber is the right ventricle since it takes over half of the anterior thoracic wall. The left ventricle is injured less often, but these patients usually have worse prognoses and higher mortality rates because such injuries lead to hemodynamic instability faster. We present a unique case of a suicide attempt in which the patient stabbed himself with a knife, penetrated the left ventricle, and survived even though he transected the second diagonal branch of the left anterior descending coronary artery and pulled the knife out of his chest.
穿透性心脏损伤虽罕见,但却是最紧急的急症之一,因为需要早期干预以防止死亡。此类损伤的死亡率,包括院前死亡,高达90%。最常受伤的心脏腔室是右心室,因为它占据了前胸壁的一半以上。左心室受伤较少见,但这些患者通常预后更差、死亡率更高,因为此类损伤会更快导致血流动力学不稳定。我们呈现一例独特的自杀未遂病例,患者用刀自刺,穿透左心室,尽管其横断了左前降支冠状动脉的第二对角支并将刀从胸部拔出,但仍存活下来。