FROM DEATH TO LIFE: A CASE REPORT ON PENETRATING CARDIAC INJURY SECONDARY TO STAB WOUND anjmacatangay@gmail.com

 

FROM DEATH TO LIFE: A CASE REPORT ON PENETRATING CARDIAC INJURY SECONDARY TO STAB WOUND

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Philippines

Poster Exhibition only

Penetrating cardiac injury (PCI) accounts for only 0.1% of all trauma admissions but carries a high mortality rate. This case highlights the life-saving impact of prompt surgical intervention in a patient who survived a near-fatal stab wound to the chest.

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Case Report: A 32-year-old male arrived at the emergency department unresponsive, with no measurable blood pressure or heart rate, after sustaining a single stab wound to the midsternal area. Cardiopulmonary resuscitation was performed, and the patient regained spontaneous circulation, though remained hypotensive—suggestive of cardiac tamponade. Blood product resuscitation was initiated, and the patient was rushed to emergency left anterolateral thoracotomy. A Grade IV cardiac injury was identified: a 3 cm stab wound to the right atrium. Temporary hemorrhage control was achieved with balloon occlusion, but the patient suffered intraoperative cardiac arrest. Open cardiac massage was performed. When pulseless ventricular tachycardia was noted, internal defibrillation at 10 joules restored sinus rhythm. Definitive repair of the cardiac wound was performed using pledgeted horizontal mattress sutures. No other injuries were identified. A left thoracostomy tube was placed and the incision was closed. The patient received multiple units of blood products and intraoperative medications including amiodarone, calcium carbonate, and magnesium sulfate. He was weaned off pressors, extubated on day three, and discharged on day eight.

Conclusion: This case underscores the importance of rapid diagnosis, immediate surgical access, and a skilled trauma team with proper resources in successfully managing penetrating cardiac injuries.