Challenges in the Management of Penetrating Cardiac Injuries in Taiz, Yemen

Ten patients with penetrating heart injury were admitted to the emergency room (ER) of Yemen International Hospital, Taiz, Yemen in the period 2011–2013. Nine patients were males and one was a female, with mean age of patients was 27.6 years old. All mechanisms of injuries were gunshot wounds except for one, which was a stab wound. Patients were classified into three groups according to their hemodynamic states and consciousness level. The first group includes five patients who were hemodynamically unstable and conscious. These patients were transferred immediately to the operating room. Patients with various heart injuries survived. The second group includes three patients who were in shock with no detectable blood pressure and semiconscious. Because there was no response to resuscitation, they were highly indicated for emergency thoracotomy, which could not be performed due to the presence of their firearms-carrying relatives in the ER. Therefore, these patients died. The third group includes two patients who were hemodynamically stable and conscious. They underwent pericardial window opening. In conclusion, penetrating cardiac injuries seen in our hospital are consistent with the available literature. However, it is believed that country security instability is one of the important factors that affects the management of such cases according to the international guidelines.