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Thorac Cardiovasc Surg · Dec 2000
Case ReportsAbsence of hemodynamic and ECG changes in a patient with traumatic left ventricular injury and puncture of the left anterior descending branch.
- M Südkamp, H J Geissler, and E R de Vivie.
- Department of Cardiothoracic Surgery, University of Cologne, Germany. michael.suedkamp@medizin.uni-koeln.de
- Thorac Cardiovasc Surg. 2000 Dec 1;48(6):373-5.
AbstractPatients with penetrating cardiac injury usually present with cardiac tamponade and shock upon hospital arrival. However, absence of hemodynamic depression does not exclude a potentially fatal injury of the heart. This article reports on a patient who developed neither hemodynamic depression nor ECG changes for several hours, despite two left ventricular lacerations with puncture of the LAD. Echocardiography is advocated as the diagnostic tool of choice, and it is emphasized that no penetrating objects should be removed from the wound before surgical access to the heart is established, as this may result in the sudden development of cardiac tamponade.
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