Cardiac Injury

Cardiac injury may result from a penetrating or blunt mechanism. With either mechanism, injury to the anterior surface of the heart is the most common. Penetrating cardiac injury (PCI) frequently presents with hemodynamic instability due to either cardiac tamponade or blood loss via a defect in the pericardium. Diagnosis can be suspected based on location of the injury in the cardiac box, physical examination, FAST, and pericardial window. Operative approaches to cardiac injury are described in the chapter. Blunt cardiac injury (BCI) differs from PCI in etiology and injury pattern. BCI ranges from an asymptomatic myocardial contusion to cardiac chamber rupture. Criteria for BCI include EKG findings, troponin levels, and echocardiography. Diagnosis of BCI remains difficult, with no consensus for the definition of BCI.