Combined left ventricle and descending aorta gunshot wound

Patients with penetrating cardiac injuries caused by a gunshot have a poor outcome [3,18]. Less than 10% of these patients reach the hospital alive [6]. Survival rates after hospital admission are reported with a percentage of 15–30 [3,18,35]. Acute traumatic aortic lesions are as well life-threatening injuries appearing typically in patients who sustain blunt deceleration trauma in car accidents or falls from a height [31,14,13]. 80–85% of the patients suffering this injury die at the scene of accident itself [29]. Gunshot wounds to the aorta are rarely reported, but penetrating trauma to the aorta is usually rapidly fatal [30,4,12]. To our knowledge there is no reported combined lesion of the left ventricle and the descending aorta due to a single gunshot bullet in the same patient. Which of these two potentially lethal injuries should be addressed first?