-
Views
-
Cite
Cite
Roberto Martín-Reyes, Miguel Angel Navas Lobato, Rafael Peinado, Angel Sánchez-Recalde, Raúl Moreno, Mar Moreno Yangüela, Jose Luis López Sendón, Ivan Gómez Blázquez, Acute myocardial infarction and mechanical complications due to a penetrating knife injury of the heart, European Heart Journal, Volume 29, Issue 15, August 2008, Page 1806, https://doi.org/10.1093/eurheartj/ehn040
Close - Share Icon Share
Extract
We report the case of a 21-year-old man who was brought to the emergency department after complaining chest pain and dyspnoea because of a stab wound in the chest. Promptly he became comatose and developed haemodynamic instability. On physical examination the jugular venous pressure was high, the blood pressure 80/50 mmHg, and the heart rate was 130 b.p.m.
A transthoracic echocardiogram was performed and cardiac tamponade was diagnosed. The patient underwent percutaneous pericardiocentesis and surgical correction by placing a bovine pericardium patch in the anterior left ventricle wall, without cardiopulmonary bypass.
Postoperative period was complicated with acute heart failure. On physical examination a new pansystolic murmur was heard. The electrocardiogram showed an established anteroseptal myocardial infarction (Figure 1A). Coronary angiography revealed cut-off in the mid left anterior descending (LAD) artery (Figure 1B). Transoesophageal echocardiography showed hyperdynamic left ventricle and akinesis of the anterior wall and apex with an image of muscle disruption in the anterior wall (Figure 2A). In long axis view was found severe mitral regurgitation because of posterior papillary muscle disruption (Figure 2B) in relation with the penetrating knife injury. Besides, an apical ventricular septal defect (Figure 2B) was found probably because of the acute myocardial infarction and apical aneurism.
