Document Detail


Stab wound to the chest with acute pericardial tamponade.
MedLine Citation:
PMID:  8969998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 21-year-old male presented to the trauma unit after he was stabbed once with a knife in the left anterior chest. The patient was awake and combative, very intoxicated, with a systolic blood pressure of 90 mmHg by palpation and a heart rate of 110 beats per min. Physical examination revealed distended neck veins, a single 1.5 cm stab wound to the left parasternal area at the third ICS (noted by clip on x-ray, Fig. 1), poorly auscultated heart sounds, and palpable femoral pulses that went away with inspiration. Chest radiograph (Fig. 1) showed a "pear-shaped" cardiac silhouette, though not markedly enlarged, and a significant left hemothorax. A diagnosis of acute pericardial tamponade was made, and the patient was taken immediately to the operating room for thoracotomy and successful repair of a stab wound of the right ventricle. Figure 2 (courtesy of Richard Wolfe, MD, Massachusetts General Hospital, Boston, MA) presents an example of an echocardiogram depicting a pericardial effusion. Pericardial fluid is imaged as a black (hypoechoic) crescent area separating the apex of the heart from the pericardium, seen as a white ring (arrow) at the inferior aspect of the scan. Tamponade is defined sonographically as the presence of both pericardial effusion (PE) and diastolic collapse of the right ventricle. Figure 3 (courtesy of Michael H. Picard, MD, of Harvard Medical School, Boston, MA) demonstrates the collapse of the right ventricular outflow track (RVOT) and its position relative to the left ventricle (LV), the left atrium (LA), and the aortic valve (AV).
Authors:
E D Barton; A Jacoby
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  14     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:    1996 Nov-Dec
Date Detail:
Created Date:  1997-03-06     Completed Date:  1997-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  743-5     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, University of California, San Diego Medical Center, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Tamponade / etiology*,  radiography,  ultrasonography
Echocardiography
Humans
Male
Pericardial Effusion / etiology,  ultrasonography
Thoracic Injuries / complications*
Wounds, Stab / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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