title: A severe penetrating cardiac injury in the absence of cardiac tamponade.
abstract: Penetrating cardiac injury is rare and frequently not survivable. Significant haemorrhage resulting in cardiac tamponade commonly ensues. Such cardiac tamponade is a clear clinical, radiological and sonographic indicator of significant underlying injury. In the absence of cardiac tamponade, diagnosis can be more challenging. In this case of a 26-year old sailor stabbed at sea, a significant pericardial effusion and cardiac tamponade did not occur despite an injury transversing the pericardium. Instead, the pericardial haemorrhage drained into the left pleural cavity resulting in a haemothorax. This case is notable due to a favourable outcome despite a delay in diagnosis due to a lack of pericardial effusion, a concomitant cerebrovascular event and a long delay from injury to appropriate medical treatment in the presence of a penetrating cardiac wound deep enough to cause a muscular ventricular septal defect and lacerate a primary chordae of the anterior mitral leaflet.
authors: Department of Surgery, University Hospital Galway, Galway, Ireland.
authors: Tara M
authors: TM
authors: Connelly
authors: Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland.
authors: Walenty
authors: W
authors: Kolcow
authors: Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland.
authors: Dave
authors: D
authors: Veerasingam
authors: Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland.
authors: Mark
authors: M
authors: DaCosta
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000209:etiology; D006335:Heart Injuries / Q000150:complications / Q000175:diagnosis*; D006345:Heart Septal Defects, Ventricular / Q000209:etiology; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000293:injuries*; D010490:Pericardial Effusion / Q000209:etiology; D014951:Wounds, Stab / Q000150:complications / Q000175:diagnosis*
keywords: Cardiac tamponade; Cardiac trauma; Penetrating chest injury; Stab wound to chest