Nail Gun Penetrating Injury of the Left Ventricle and Descending Aorta
A17-year-old boy was sent to the emergency service for an accidental nail-gun shot injury of the chest. His blood pressure was 90/60 mm Hg, heart rate was 110 bpm, and oxygen saturation was 87% before anesthetic induction in the operating room. Transesophageal echocardiography undertaken after induction with general anesthesia and endotracheal intubation showed that the left ventricle and descending aorta were penetrated by the nail. There was large amount of pericardial effusion with cardiac tamponade. Periaortic hematoma was evident by transesophageal echocardiography. Under partial cardiopulmonary bypass, the nail was removed, and the wounds of the left ventricular wall and descending aorta were repaired. The patient was discharged uneventfully 7 days after the accident.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
- Copyright © 1999 by American Heart Association