Penetrating Cardiac Injury
This chapter deals primarily with all features in penetrating cardiac wounds, considered the most common cause among cardiac injuries, with the predominant cause being gunshot and stab wounds. Cardiac injuries are exceedingly devastating lesions and present a great challenge because these injuries require urgent and emergency intervention to prevent death. Sometimes serious cardiac injury may manifest only subtle or occult symptoms or signs. Particular attention is given to the topic of the cardiac box, the area where all penetrating trauma may determine an injury to the heart structures and the great vessels. A diagnostic algorithm is discussed in order to obtain an immediate right diagnosis and to transfer the patient immediately in surgery. Surgical techniques in both gunshot and stab wounds are explained and several cases are illustrated. Furthermore, we describe procedural complications in interventional cardiology, some illustrative clinical cases, and a case scenario.
KeywordsPenetrating cardiac wound Cardiac box Cardiac tamponade Hemothorax e-FAST (extended focused assessment with sonography for trauma) Iatrogenic trauma
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