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Cardiac trauma

Trauma Surgery ‘A’ Service, Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, USA., asensio{at}hsc.usc.edu

Gustavo Roldán

Trauma Surgery ‘A’ Service, Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, USA

Patrizio Petrone

Trauma Surgery ‘A’ Service, Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, USA

Walter Forno

Trauma Surgery ‘A’ Service, Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, USA

Vincent Rowe

Department of Surgery, University of Southern California, LAC USC Medical Center, USA

Ali Salim

Trauma Surgery ‘A’ Service, Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, USA

The first description of a cardiac injury is found in The Iliad. Cardiac injuries are one of the most challenging injuries, requiring immediate surgical intervention, excellent surgical skills and critical care. The clinical presentation of penetrating cardiac injuries has a broad range, from haemodynamic stability to cardio-pulmonary arrest. Two-dimensional echocardiography is now the procedure of choice over subxiphoid pericardial window to evaluate for the presence of these injuries. Emergency department thoracotomy is indicated for management of penetrating cardiac injuries with immediate cardiography, aortic cross-clamping and open cardiac massage. The left anterolateral thoracotomy is the incision of choice for patients that arrive in extremis. The repair of the wounds should be performed according to the anatomy of the injured area. Mortality remains high, although better patient selection according to physiologic scoring leads to increase in survival.

Key Words: cardiac trauma • emergency thoracotomy • pericardial window

Trauma, Vol. 3, No. 2, 69-77 (2001)
DOI: 10.1177/146040860100300201


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