Injury to the conduction system: management of life-threatening arrhythmias after penetrating cardiac trauma

Jhunjhunwala, Rashi; Dente, Christopher J.; Keeling, W. Brent; Prest, Phillip J.; Dougherty, Stacy D.; Gelbard, Rondi B.; Long, William B.; Nicholas, Jeffrey M.; Morse, Bryan C.

doi:10.1016/j.amjsurg.2015.07.034

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…Most post-traumatic arrhythmias are consequence of blunt thoracic trauma [8]. Cardiac conduction system injuries secondary to pene- trating traumas are a rare but equally life-threatening condition, and their rapid recognition and management are critical to improve chances of survival [7].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Penetrating Injury with Complete Heart Block: A Case Report

et al. 2022

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The development of heart block following cardiac penetrating injury is rare, and only few cases can be found in the literature. This uncommon healthcare emergency has shown to be a medical challenge for healthcare personnel, and it manifests very high mortality rates of 80–90% among its victims. The pre-hospital management and transport time for these cases are vital and can dictate the possible outcome for the victim. In this article, we present the first case ever reported in the Gulf Region about complete heart block as a consequence of penetrating chest injury. Our patient was a 35-year-old male who had a stab wound on the right side of chest wall and who developed complete heart block in the Emergency Department (ED) as a result of the injury. Patient was rapidly diagnosed and managed in ED and then was shifted to the operating theater for immediate surgical repair. However, despite anatomical correction during the surgery he remained hypotensive and bradycardic. When a hemodynamic stability was achieved, he was then placed on a temporary pacemaker and later on a permanent pacemaker by the cardiology team.

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Section: Discussionmentioning

confidence: 99%

Cardiac Penetrating Injury with Complete Heart Block: A Case Report

et al. 2022

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“…Subsequent cardiac assessment should incorporate differentiation of hemorrhagic, dynamic, or stenotic causes of infarction. Complete heart block and other conduction system abnormalities, which have been reported to occur in 2.8% of PCI patients, may warrant temporary placement of epicardial wires or transvenous pacing [ 62 ]. Possible symptoms, such as new murmurs or dyspnea on exertion, can alternatively indicate ventricular septal defects which are less common and can be managed conservatively in asymptomatic patients.…”

Section: Postoperative Care and Pitfallsmentioning

confidence: 99%

Penetrating cardiac trauma

Lee¹,

Hameed²,

Kaminsky³

et al. 2023

Surgery Open Science

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“…Complete heart block and other conduction system abnormalities, which have been reported to occur in 2.8 % of patients with penetrating cardiac injuries, may warrant temporary placement of epicardial wires or transvenous pacing. 62 Findings, such as exertional dyspnea or new murmurs, may suggest an E591 intracardiac injury such as a ventricular septal defect, which may require transcatheter closure, depending on the magnitude of associated symptoms. Similarly, other complex cardiac sequelae such as valvular injuries require close multidisciplinary communication and teamwork.…”

Section: Postoperative Care and Pitfallsmentioning

confidence: 99%

Technical considerations in the management of penetrating cardiac injury

Ball

Lee

Kaminsky

et al. 2022

cjs

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Technical considerations in the management of penetrating cardiac injuryPenetrating cardiac injuries require rapid diagnosis, efficient exposure and nuanced technical approaches, within a framework of highly coordinated and integrated multidisciplinary care. Acute care surgeons, with both strategic and technical expertise, are ideally positioned to address the potentially dev astating consequences of these injuries. The aim of this narrative review is to offer a technical approach to the rapid evaluation, exposure, operative repair and postoperative care of penetrating cardiac injuries. A comprehensive review of the cardiac trauma literature, dating back to 1970, has provided a detailed toolbox of approaches to subxiphoid pericardial windows, resuscita tive thoracotomy, median sternotomy, pericardiotomy, aortic clamping, car diac hemorrhage control, cardiac repair, coronary artery injuries, pericardial closure, drain placement, chest wall closures, damage control thoracic pro cedures and immediate postoperative cardiac care, all based on fundamental physiological principles and anatomical considerations. First principles Team dynamics and responsibilitySuccess in the management of penetrating cardiac injuries depends on the presence of predefined systems of trauma care capable of moving patients quickly, accessing necessary resources (e.g., blood bank) and equipment (e.g., resuscitative thoracotomy tray [Figure 1], operating

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Injury to the conduction system: management of life-threatening arrhythmias after penetrating cardiac trauma

Cited by 12 publications

References 5 publications

Cardiac Penetrating Injury with Complete Heart Block: A Case Report

Cardiac Penetrating Injury with Complete Heart Block: A Case Report

Penetrating cardiac trauma

Technical considerations in the management of penetrating cardiac injury

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