Management of a Traumatic Penetrating Cardiac Injury in a Low-Resource Center Without a Cardiothoracic Surgery Department

TL;DR

This paper describes how a rare heart injury was successfully treated by general surgeons in a low-resource hospital without a cardiothoracic surgery department.

Contribution

It highlights the capability of general surgeons to manage complex cardiac injuries in the absence of specialists.

Findings

A penetrating cardiac injury was successfully managed by general surgeons in a low-resource setting.

The case demonstrates that Caribbean hospitals can achieve high medical standards with additional resources.

General surgeons can play a critical role in trauma care when specialists are unavailable.

Abstract

Traumatic penetrating cardiac injury is a rare pathology with a high mortality rate, more commonly occurring in a military setting or during violent assaults in a civilian environment. Given the anatomy, these injuries are often managed by cardiothoracic surgeons. However, in an institute that lacks these specialists, the responsibility for managing this condition falls on the shoulders of the general surgeon on call. We herein report a case where a penetrating cardiac injury was managed successfully by general surgeons in the absence of cardiothoracic surgeons. This case serves two educational purposes. The first is that Caribbean hospitals possess the potential to match a developed country's medical standard if additional resources can be obtained from their respective governing bodies. The second is that a general surgeon’s role is not yet finished in the modern era of sub-specialization, especially in a setting that lacks dedicated specialists.

Figures