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.
Heller RF, Rahimtoola SH, Ehsani A, et al. Cardiac Complications: Results of Penetrating Chest Wounds Involving the Heart. Arch Intern Med. 1974;134(3):491–496. doi:10.1001/archinte.1974.00320210101014
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