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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest wall lesion &#40;A&#41; and transthoracic echocardiographic images showing a circumferential and large pericardial effusion &#40;B&#41;&#44; as well as turbulent flow in aortic root and a severe aortic valve regurgitation &#40;C&#41;&#59; fistulous communications between both the right ventricle and left atrium to the aortic root were suspected in the parasternal short axis view &#40;D&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 22-year-old male was admitted to the emergency room due to a left hemithorax injury from a screwdriver &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1A</a>&#41;&#46; The patient was hemodynamically stable&#44; with a slightly altered mental status&#46; Chest computed tomography was performed and revealed moderate pericardial effusion&#44; leading to an evaluation by the cardiology emergency team&#46; The transthoracic echocardiogram revealed severe aortic valve regurgitation&#44; raising suspicion of aortic root injury&#44; as well as fistulous communications between heart chambers &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1B&#8211;D</a>&#41;&#46; These findings led to emergent surgery&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Intraoperative transesophageal echocardiogram images confirmed an injury path originating in the right ventricle&#44; crossing the aortic valve root&#44; and ending in the left atrium &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2A&#8211;C</a>&#41;&#46; An aortic valve replacement&#44; closure of the aortic root fistulas and infundibular lesion were performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2D</a>&#41;&#46; The patient had excellent postoperative recovery and was discharged after six days&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Our case reports an apparently stable patient despite worrisome echocardiographic findings&#44; especially traumatic valve injury&#44; which is a rarely reported lesion&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> It is an astonishing case due to a lucky &#40;millimetric&#41; save from an open aortic injury&#44; which is fatal in most cases&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We emphasize the high mortality rates associated with penetrating cardiac injury<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> and the importance of keeping a high index of suspicion for these lesions after chest trauma&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Furthermore&#44; we underline how stab injuries may present with subtle imaging findings&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> hindering their recognition and justifying the crucial role of cardiac imaging for early diagnosis and correct management&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3&#44;4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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