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November 5, 1938

THE DIAGNOSIS AND TREATMENT OF WOUNDS OF THE HEARTA REVIEW OF TWENTY-TWO CASES

Author Affiliations

ATLANTA, GA.

From the Department of Surgery, Emory University School of Medicine.

JAMA. 1938;111(19):1750-1753. doi:10.1001/jama.1938.72790450002010
Abstract

Wounds of the heart demand early diagnosis and operation, for delay is rapidly fatal. Every attempt at accurate diagnosis should be made before operation, since exposure of the heart is in itself hazardous. The occasion for cardiorrhaphy arises rarely and always in cases in which immediate intervention is required; therefore the surgeon should have in mind the definite principles involved in the diagnosis and treatment. The object of this paper is to review twenty-two cases in which operation was performed and to set out certain principles based on that experience.

GENERAL CONSIDERATIONS 

Incidence.—  Wounds of the heart are relatively rare. At the Medical College of Virginia Hospitals 0.1 per cent of surgical patients had such injuries,1 and in my own experience2 approximately 2 per cent of penetrating wounds of the chest injured the heart. Considering the size of the heart in relation to the chest and its

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