Successful management of a penetrating cardiac injury in a surgical department of sub-Saharan Africa: A case report.

INTRODUCTION AND IMPORTANCE

Cardiac wounds are uncommon injuries with a high mortality rate. The number of successfully treated patients is increasing in countries with developed health care systems. However, in sub-Saharan Africa survival rates remain low. This article shares our experience with a patient who survived a cardiac wound at our center.

CASE PRESENTATION

A 21-year-old man was admitted to our emergency department with a stab wound on the chest. On arrival, he presented with signs of hemorrhagic shock and cardiac tamponade confirmed by Focused Assessment with Sonography in Trauma (FAST) which showed a positive pericardial effusion. A cardiac wound was suspected, and the patient was transferred to the operating room by the general surgery team. The wound in the right ventricle was repaired via thoracotomy under general anesthesia and orotracheal intubation. The postoperative course was uneventful.

CLINICAL DISCUSSION

There is still a high death rate in many parts of the world where there is no developed prehospital care system, such as Senegal. Successful management of cardiac wounds depends on early diagnosis and proper training in trauma patient care. Surgical treatment is straightforward and should be performed by a surgeon working in the emergency department.

CONCLUSION

Successful management of cardiac wounds remains a significant challenge. Surgical treatment is simple in principle and should be possible for any general surgeon working in the emergency department. This positive result is a significant achievement for our medical team, our doctors in training, and the history of our center.