Heart bleeding, these are the reasons you have to know

The phenomenon of cardiac bleeding obviously needs to attract people's attention. It must be said that cardiac bleeding can endanger people's lives to a certain extent. Therefore, after cardiac bleeding occurs, we must find out the cause as soon as possible so as to take appropriate measures for treatment. So, what are the specific causes of heart bleeding?

Causes of heart bleeding

Most of them are caused by sharp objects such as knives, bullets, shrapnel, etc. penetrating the chest wall and injuring the heart. In a few cases, the heart ruptures due to violent impact on the chest. When myocardial infarction has not been relieved for more than 6 to 7 hours, the myocardium will soften due to neutrophil infiltration, and heart rupture may occur under the impact of blood flow, which is one of the important complications of myocardial infarction. The most common rupture is right ventricular rupture, followed by left ventricle and right atrium. Rupture and bleeding of large blood vessels in the left atrium and pericardium are rare.

Symptoms of heart bleeding

If the heart bleeds and the pericardial rupture remains open, blood will flow out of the wound in the front chest or into the pleural cavity. Clinical signs of hypovolemia appear: such as pale complexion, shallow and weak breathing, rapid pulse, and decreased blood pressure. The patient may quickly fall into shock and die from massive bleeding. The injured person was in shock and complained of chest pain, rapid breathing, rapid heart rate, weak heart sounds, rapid pulse rate, weak pulse volume, low blood pressure, distended jugular veins, and increased venous pressure. Emergency treatment should be initiated immediately based on the traumatic history and the above signs. Although pericardial puncture to draw fresh blood can confirm the diagnosis and temporarily relieve the symptoms of cardiac tamponade, approximately 25% to 40% of the injured are unable to draw blood due to blood clots. Puncture may also cause damage to coronary artery branches. After a patient with a ruptured heart is sent to the hospital, if only multiple pericardiocentesis is performed to treat the hemopericardium, the mortality rate can be as high as over 60%. However, if a thoracotomy is performed immediately after a clear diagnosis by pericardiocentesis to repair the heart rupture, the mortality rate can be reduced to less than 20%. During the operation, blood volume should be replenished and shock should be corrected. In patients with heart rupture and massive hemothorax, the pressure on the heart is relatively light and the pleural cavity can be drained first while replenishing the blood volume. If bleeding continues and the pleural cavity drainage volume is large, thoracotomy should be performed as soon as possible.

Treatment for heart bleeding

If the heart ruptures and bleeds, surgery should be performed immediately. Acute pericardial tamponade is often a critical condition. Pericardial puncture can be performed first to relieve the pressure, while blood transfusion and fluid replacement can be performed at the same time to buy time for thoracotomy and rescue. Generally, the doctor enters the chest through the 4th intercostal space of the left anterior chest, incises the pericardium, removes the accumulated blood, explores the bleeding point or rupture of the heart wall, presses with fingers to stop the bleeding, and then performs interrupted suture repair. Small branch bleeding of the coronary artery can be sutured; if it is the left anterior descending artery or other main branches, suture ligation plus coronary artery bypass surgery is required under extracorporeal circulation.