Complete heart block following penetrating chest trauma in operation Iraqi freedom.
We present a 30-year-old US army soldier who had penetrating chest trauma from a road side explosive with focal cardiac injury. The soldier had penetration of his right atrium and subsequent traumatic membranous ventricular septal defect and complete heart block. He was brought to a Combat Support Hospital where fortuitously the assigned trauma surgeon on-call was a cardiothoracic surgeon, and the assigned trauma intensivist on-call was a cardiac electrophysiologist. Of course, the only source they knew of a pacemaker was halfway around the world. We discuss the management of this injury in an austere combat environment.
Eckart
Robert E
RE
28th Combat Support Hospital, Task Force North, Ibn Sina Hospital, Baghdad, Iraq. robert.eckart@us.army.mil
Falta
Edward M
EM
Stewart
Robert W
RW
D000328:Adult; D003422:Critical Care / Q000379:methods*; D006327:Heart Block / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D010138:Pacemaker, Artificial; D013898:Thoracic Injuries / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications* / Q000628:therapy*