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| ==Background==
| | *[[Blunt cardiac injury]] |
| ===Penetrating Trauma===
| | *[[Penetrating cardiac injury]] |
| *Location | |
| **Stab wounds
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| ***Usually affect heart if enter via the "cardiac box"
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| ****Chest area bounded by sternal notch, xiphoid, and nipple
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| **GSW can affect heart even if enters at distant site
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| *Ventricles are at greatest risk due to anterior location
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| **RV (involved in 40% of injuries)
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| **LV (involved in 35% of injuries)
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| **RA (involved in 20% of injuries)
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| **LA (involved in 5% of injuries)
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| *Cardiac missiles
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| **Those that cause BP instability, free or partially exposed should be removed
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| **Most intramyocardial and intrapericadrial bullets can be left in place
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| ===Blunt Trauma===
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| *Up to 20% of all MVC deaths are due to blunt cardiac injury
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| *Most often involves the right heart (due to ant location)
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| **Injury to valves occurs in 10%
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| *May present as:
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| **MI (coronary artery injury)
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| **Acute heart failure (valve rupture)
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| **Dysrhythmias
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| ==Workup==
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| *FAST
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| **Pericardial fluid detection (Sn 100%, Sp 97%)
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| *ECG
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| **NPV for a normal ECG is 80-90%
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| **Not as sensitive for right-sided injuries
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| *Troponin
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| **Trend in all pts
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| **Combination of normal ECG and normal troponin 100% sn in one study
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| ==Treatment==
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| *[[Thoracotomy]]
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| *[[Pericardiocentesis]] | |
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| ==Disposition==
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| ==See Also==
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| [[Commotio Cordis]]
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| ==Source==
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| [[Category:Trauma]] | | [[Category:Trauma]] |
| | [[Category:Cardiology]] |
