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LESÃO DE 0,5 CM PRECISAMENTE LOCALIZADA NO VENTRÍCULO ESQUERDO EM VÍTIMA DE SUICÍDIO POR FACA DE MESA: RELATO DE CASO
Jairo Joaquim Dos Santos Júnior (1)
http://lattes.cnpq.br/8009832338959999 – https://orcid.org/0000-0002-9868-4695
Luciana Maria Prado Gomes (2)
https://lattes.cnpq.br/9842852380177794 – https://orcid.org/0000-0001-8231-3788
Danilo Guimarães Siqueira (2)
http://lattes.cnpq.br/8724405779200894 – https://orcid.org/0000-0002-6953-5041
Victor Vasconcelos Barros (3)
http://lattes.cnpq.br/9991006988660508 – https://orcid.org/0000-0003-3227-3604
(1) Universidade Tiradentes,Faculdade de Medicina, Departamento de Estágio de Medicina Legal pela secretaria de segurança pública do estado de Sergipe. Aracaju-SE, Brasil.
(Autor principal)
(2) Universidade Tiradentes,Faculdade de Medicina, Aracaju-SE, Brasil. (Autor secundário)
(3) Escola Bahiana de medicina e saúde pública, Departamento de Medicina Legal, Aracaju-SE, Brasil. (Orientador)
Email: jairo.joaquim@souunit.com.br
ABSTRACT
Between 2010 and 2019, there were 112,230 deaths by suicide in Brazil, with a 43% increase in the annual number of deaths, from 9,454 in 2010 to 13,523 in 2019 (1). In this paper, a case of a victim of self-harm by a sharp instrument will be reported, which caused cardiac tamponade and evolved to death, on the spot, with cause of death: cardiogenic shock. Reviewing the cadaveric report, obtained at the Instituto Médico Legal de Sergipe, in order to understand the mechanism of the cardiac trauma and its severity, which caused 600ml of hemorrhagic contente to fill in the pericardium. What draws attention would be the precision of the wound, as it is a self-inflicted injury, with ruptures of several anatomical physical barriers, reaching the heart with a 0.5 cm lesion, in the left ventricle, with a single blow and a malleable object, a table serrated knife, with characteristics of low resistance and low piercing power, when compared to other sharp instruments of greater lethality. There is a high prevalence in victims of penetrating cardiac injury who die before receiving advanced life support. Among those who arrive at the hospital, a small part may be hemodynamically stable and without clinical signs suggestive of cardiac injury. Exsanguination is responsible for most deaths from cardiac trauma and cardiac tamponade was present in second place.
Keywords: Cardiogenic shock, cardiac tamponade, sharp injury, pericardium.
Bibliographical references
- Mortalidade por suicídio e notificações de lesões autoprovocadas no Brasil [Internet]. [citado em 3 mar. 2023] Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/edicoes/2021/boletim_epidemiologico_svs_33_final.pdf.
- Silva NC. Tamponamento cardíaco agudo: uma breve revisão. Rev Méd Minas Gerais. 2008;18(3)Supl 4 S37-S40.
- Araújo AO et al. Trauma cardíaco fatal na cidade de Manaus/AM, Brasil. Rev Col Bras Cir., v. 45, 4 out. 2018.
- IML atua somente em casos de mortes violentas e não naturais. Notícias – mt.gov.br. [Internet]. [citado em 6 out 2022]. Disponível em: http://www.mt.gov.br/-/15259026-iml-atua-somente-em-casos-de-mortes-violentas-e-nao-naturais#:~:text=Cabe%20ao%20IML%20a%20remo%C3%A7%C3%A3o.
- Bittar N. Medicina legal e noções e criminalística. 11. ed. Indaiatuba: Foco; 2022.