Current evaluation of cardiac stab wounds

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dc.contributor.authorHarris D.G.
dc.contributor.authorPapagiannopoulos K.A.
dc.contributor.authorPretorius J.
dc.contributor.authorVan Rooyen T.
dc.contributor.authorRossouw G.J.
dc.date.accessioned2011-05-15T16:15:32Z
dc.date.available2011-05-15T16:15:32Z
dc.date.issued1999
dc.description.abstractBackground. Patients with penetrating cardiac injuries may be stable or only mildly shocked, especially if the laceration has sealed off and the patient has been aggressively resuscitated. Clinical signs, chest roentgenograms, pericardiocentesis, and subxiphoid window are not always helpful in establishing the diagnosis. We reflect on the current evaluation based on 128 patients. Methods. There were four groups of patients, ranging from lifeless (group I) to stable (group IV). Patients in groups I and II were prepared immediately for operation. Those in groups III and IV were often investigated further (chest roentgenogram and cardiac ultrasound). Results. Mortality was 8%. Significant findings were a precordial stab, central venous pressure of more than 15 cm of water, one or more clinical signs of tamponade, and initial shock. Cardiac ultrasound was performed in 5 patients in group II (15%), 14 patients in group III (48%), and 37 patients in group IV (86%). There were no false positives, and 6 false negatives (11%). Thirty-one patients (24%) had clotted lacerations. There were no negative sternotomies. Conclusions. Efficient fluid resuscitation and rapid confirmation of diagnosis with cardiac ultrasound should decrease mortality. Stable patients with a precordial wound should undergo cardiac ultrasound or echocardiogram. Diagnosis may be reliably confirmed in these patients whose clinical signs often fluctuate (or rapidly deteriorate).
dc.description.versionArticle
dc.identifier.citationAnnals of Thoracic Surgery
dc.identifier.citation68
dc.identifier.citation6
dc.identifier.issn00034975
dc.identifier.other10.1016/S0003-4975(99)00711-0
dc.identifier.urihttp://hdl.handle.net/10019.1/13378
dc.subjectadult
dc.subjectarticle
dc.subjectcentral venous pressure
dc.subjectchild
dc.subjectclinical feature
dc.subjectechocardiography
dc.subjectfemale
dc.subjectheart injury
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality
dc.subjectpatient coding
dc.subjectpreschool child
dc.subjectpriority journal
dc.subjectschool child
dc.subjectstab wound
dc.subjectAdolescent
dc.subjectAdult
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectFemale
dc.subjectHeart Injuries
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectSurvival Rate
dc.subjectWounds, Stab
dc.titleCurrent evaluation of cardiac stab wounds
dc.typeArticle
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