Clinical study of cardiac injuries
Mashiko, K.; Kanazawa, M.; Yamamoto, Y.; Henmi, H.; Otsuka, T.; Ikeshita, M.; Chujo, Y.; Tanaka, S.; Yamate, N.; Shoji, T.
Nihon Kyobu Geka Gakkai 28(2): 278-291
1980
ISSN/ISBN: 0369-4739 PMID: 7381253 Document Number: 164941
Cases [23] of cardiac injuries at an Emergency Center consisted of 9 penetrating cardiac injuries, 11 non-penetrating cardiac injuries, 2 iatrogenic cardiac injuries and 1 cardiac foreign body. The penetrating cardiac injuries were all stab injuries which were located in the left ventricle in 3 cases, the right ventricle in 2 cases, ventricular septum in 1 case and at the pericardium in 4 cases. Of these penetrating cardiac injury cases, 8 were subjected to thoracotomy and all survived. The non-penetrating cardiac injuries consisted of 7 traffic accidents and 4 falls. They were composed of 1 cardiac rupture, 3 pericardial ruptures and 8 myocardial contusions. Cardiac prolapses on the left side were seen in 1 of 3 pericardial ruptures. Of these 11 cases, 6 died of hemorrhagic shock, cardiogenic shock or other complicated injuries. In 2 cases of iatrogenic cardiac injuries, the left atrium was perforated with the cardiac catheter. One patient died after an open mitral commissurotomy. The foreign body case was a residue of CVP catheter of 40 cm length from inferior vena cava to the right pulmonary artery; it was successfully removed. Low blood pressure, tachycardia, tachypnea, hypoxia and metabolic acidosis were observed and the chest X-rays showed cardiac enlargement, hemothorax, pneumothorax, s.c. emphysema, fractures of ribs or clavicles, pneumopericardium and pulmonary contusion. Using the ECG, various abnormalities such as sinus tachycardia and ST elevation were found. As complications, pulmonary injuries were seen in 6 of 9 penetrating cases and multiple injuries were seen in the non-penetrating injury cases.