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September 1974

Cardiac Complications: Results of Penetrating Chest Wounds Involving the Heart

Author Affiliations

From the departments of adult cardiology (Drs. Johnson, Rahimtoola, Ehsani, and Rosen), medicine (Dr. Heller), and cardio-thoracic surgery (Dr. Tatooles), and the Trauma Unit of the Hektoen Institute for Medical Research (Dr. Boyd), Cook County Hospital; and departments of medicine (Drs. Rahimtoola, Loeb, and Rosen) and surgery (Dr. Boyd), Abraham Lincoln School of Medicine, University of Illinois College of Medicine, Chicago. Dr. Heller is now at St. Mary's Hospital Medical School, London; Dr. Rahimtoola is at the University of Oregon Medical School, Portland; and Dr. Loeb is at the Loyola Stritch University School of Medicine, Chicago.

Arch Intern Med. 1974;134(3):491-496. doi:10.1001/archinte.1974.00320210101014

Twenty-seven patients had penetrating chest trauma that involved the heart during a 21-month period of a prospective study. One patient died. Seventeen patients were treated with emergency surgery. Electrocardiograms showed pericarditis changes in all patients.

Fifteen patients (56%) developed 18 cardiac complications. Five of these (33%) needed definitive therapy. Cardiac complications included (1) late onset hemopericarditis and cardiac tamponade; (2) myocardial infarction; (3) complete heart block; (4) intracardiac defects (including ventricular septal defect, aorto-right ventricular communication with aortic incompetence, and a combination of the two), and (5) anterior descending coronary artery aneurysm with coronary arteriovenous fistula and left ventricular aneurysm.

There is a high incidence of serious cardiac complications in patients with penetrating chest trauma involving the heart, and close follow-up of these patients is important.

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