Cardiac complications. Results of penetrating chest wounds involving the heart.

Abstract

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.