MRI OF THE CONSEQUENCES OF A 30-YEAR-OLD STAB WOUND TO THE HEART

 

Kolesnikov N.P.¹, Stukalova O.V.¹, Khachatryan N.T.¹, Ustyuzhanin D.V.¹, Ternovoy S.K.^1,2

 

1 – E.I. Chazov National Medical Research Centre of Cardiology.

2 – Sechenov University. Moscow, Russia.

С

ardiac stab wound is a rare variant of penetrating chest wounds, characterized by high mortality in case of untimely treatment or incomplete assessment of the severity of the lesion in the first hours after injury. Echocardiography and computed tomography are used for emergency diagnosis of the injury in the acute period; magnetic resonance imaging is used for clarifying diagnosis in the delayed period.

Purpose. To reflect the role of magnetic resonance imaging in diagnostics of cardiac structural changes in patients with a history of cardiac injury more than 30 years ago.

Materials and methods. Clinical data and results of radiological methods of investigation of a 50-year-old man with a stab wound of the heart with closure of the right ventricular wall defect in the anamnesis and complaints of dyspnoea, pain behind the sternum at exercises, who was admitted to the E.I. Chazov National Medical Research Centre of Cardiology (Moscow), are presented.

Results. The diagnosis of an acquired interventricular septal defect associated with a stab wound of the heart was suspected on the basis of echocardiography data and further confirmed by magnetic resonance imaging data, together with the first detected damage of the lateral wall of the left ventricle.

Discussion. The highlights of this clinical case was the fact that the stab wound of the heart was initially considered only as a wound of the right ventricular wall. Thirty years later, using radiological diagnostic methods, it was possible to assess the true extent of the damage and to reveal that in addition to the right ventricular wall, the interventricular septum and the lateral wall of the left ventricle were damaged.

Conclusion. The data of magnetic resonance imaging as a method of clarifying diagnostics in cardiac injuries allowed for the first time in decades after the injury to assess the full volume of cardiac damage and to choose the correct tactics of patient management.

 

Keywords: cardiac trauma, stab wound, contrast-enhanced cardiac MRI, acquired interventricular septal defect.

 

Corresponding author: Kolesnikov N.P., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Kolesnikov N.P., Stukalova O.V., Khachatryan N.T., Ustyuzhanin D.V., Ternovoy S.K. MRI of the consequences of a 30-year-old stab wound to the heart. REJR 2024; 14(2):129-135. DOI: 10.21569/2222-7415-2024-14-2-129-135.

Received: 27.04.24 Accepted: 05.06.24