Abstract
Penetrating cardiac injury remains a highly lethal form of trauma today. Although the incidence in European countries is low (approximately 0.1% of all hospital- admitted traumas), the mortality rate ranges between 80 and 94% due to cardiac tamponade or exsanguination.
Due to the anatomic position of the heart, right ventricle injury dominates, followed by injury of the left ventricle, right atrium, and great vessels. Concomitant coronary artery injury is present in 3- 9% of all cases.
The only meaningful treatment is a scoop- and- run approach and emergency operative intervention. Pericardial effusion (> 5mm) confirmed by sonography or CT-angiography in a thoracic penetrating trauma is an indication for surgical intervention.
Hemodynamic instability, cardiac arrest, electromagnetic dissociation and prolonged injury- to- gate time represent independent risk factors for death. However, the survival rate of patients revised by a cardiothoracic surgeon ranges from 80% to 100%, with a high chance of returning back to normal life.