Young Writers Society

Hey,

I am writing a scene, where a guy had found himself in the middle of a terrorist attack, and has a tiny piece of metal stuck next to his heart. He will obviously be killed if it invades the heart and the doctors are struggling to remove it, because it's too close to it already.

I was wondering: if the fragment of the bomb did brush his heart with a sharp edge and cut him slightly (as you would say with a penknife or a sheet of paper if you were not careful), would he die right on the spot or would they be able to do something to save his life? I was thinking of maybe 'killing' him for a moment, and then having the doctors 'resuscitate' him somehow...
Would it have any implications on the recovert process and what would be the possible consequences?

I know it sounds really stupid, but I need to finish it quickly for my writing class and they don't exactly teach you about heart surgery in high-school biology classes

I'll be extremely grateful for any and all help DD Please, I really need advice...

I hope this reply isn't too late.

I'm not a biologist, I just did some google research.

The two main dangers of a physical wound to the heart are the cardiac failure and the internal bleeding.

Having an object invade the heart is one thing. The dangerous part is actually removing it. What seems to be the defining factor in the news reports I've read are whether the object goes straight through the heart, or gets lodged into it. Those who get the object lodged and go to hospital are more likely to survive.

The trouble is that you have huge amounts of blood going to and from the heart, more so in circumstances of panic. So if the object grazed the outside of the heart it wouldn't be as bad as if it split through one of the huge veins going to or from it.

If you want your character to be revived then it might be better having an object that punctures the muscle. This is more likely to damage the muscle and so cause cardiac failure or arrest. A few zaps and some life support machines could theoretically keep his body alive until the heart is repaired.

Then the complications, apart from the general issues of infection and reopening the wound, would be the lasting effects of oxygen starvation to various parts of the body, mainly the brain.

Here's a few links:
http://www.fi.edu/learn/heart/structure/structure.html
http://www.nytimes.com/2000/03/07/us/na ... vives.html
http://www.cbsnews.com/8301-504763_162- ... ugh-heart/

I happen to have Kumar and Clark open on CVS.

Okay.

Think about your anatomy. Your heart is basically in the centre of your chest. Boom. Feel it? Right there. Now, it's encased in a special layer of tissue called pericardium that's attached to the diaphragm. To the back and either side are nicely perfused lungs. There might be a pneumothorax or a haemothorax.

I'm not actually sure about stabbing the heart, if it scratched the myocardium of the left ventricle it would probably still function, but he'd be bleeding out and would basically probably be having the symptoms of a heart attack. If it went the whole way through the wall of the chamber then he'd probably die, because his heart wouldn't be pumping properly.

Are they resuscitating him in hospital? That'd be plausible, but they're really not going to be able to repair his heart in the field.

If you wanted an amazing idea, how about a tension pneumothorax? Basically, there's a lung collapse and air going into the space between the lung and the chest wall. Every breath you take, because there's a hole in the lung itself, makes the air in there bigger, and it slowly crushes everything in your chest.

How do you save someone with a tension pneumothorax? You get a big needle, and you stab them in the chest. Air whooshes out.

I don't know, say it had been lodged in his skin (blocking the hole) and then just grazed his lung, making a hole in the lung... Just a thought.

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