Abstract
Background: The pericardial window in a focused assessment with sonography for trauma (FAST) examination is highly accurate for detecting hemopericardium and, therefore, associated cardiac injury. A series of patients with false-negative pericardial ultrasound examinations, who were subsequently diagnosed with cardiac lacerations after presenting with stab wounds, are described. Methods: All patients with a normal pericardial ultrasound examination, despite subsequent diagnosis of a cardiac injury, are described (2005-2008). Results: Five patients with stab wounds to the precodium displayed initial and repeatedly normal pericardial windows on a FAST examination. Each patient was eventually diagnosed with a penetrating cardiac injury and concurrent laceration of their pericardial sac. This combination of injuries allowed decompression of blood from the cardiac injury into the thoracic cavity and, therefore, prevented accumulation of a hemopericardium. ConclusionS: The pericardial component of the FAST examination is commonly used for patients who present with penetrating wounds to the precordium. In cases of concurrent lacerations of the pericardial sac, pericardial ultrasound may not detect a cardiac injury because of associated decompression into the thoracic cavity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1123-1124 |
| Number of pages | 2 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 67 |
| Issue number | 5 |
| DOIs | |
| State | Published - Dec 1 2009 |
| Externally published | Yes |
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Keywords
- Cardiac
- Hemopericardium
- Penetrating
- Pericardial
- Tamponade
- Ultrasound
ASJC Scopus subject areas
- Surgery
- Critical Care and Intensive Care Medicine
Cite this
A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. / Ball, Chad G.; Williams, Brian H.; Wyrzykowski, Amy D.; Nicholas, Jeffrey M.; Rozycki, Grace; Feliciano, David V.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 67, No. 5, 01.12.2009, p. 1123-1124.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds
AU - Ball, Chad G.
AU - Williams, Brian H.
AU - Wyrzykowski, Amy D.
AU - Nicholas, Jeffrey M.
AU - Rozycki, Grace
AU - Feliciano, David V.
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background: The pericardial window in a focused assessment with sonography for trauma (FAST) examination is highly accurate for detecting hemopericardium and, therefore, associated cardiac injury. A series of patients with false-negative pericardial ultrasound examinations, who were subsequently diagnosed with cardiac lacerations after presenting with stab wounds, are described. Methods: All patients with a normal pericardial ultrasound examination, despite subsequent diagnosis of a cardiac injury, are described (2005-2008). Results: Five patients with stab wounds to the precodium displayed initial and repeatedly normal pericardial windows on a FAST examination. Each patient was eventually diagnosed with a penetrating cardiac injury and concurrent laceration of their pericardial sac. This combination of injuries allowed decompression of blood from the cardiac injury into the thoracic cavity and, therefore, prevented accumulation of a hemopericardium. ConclusionS: The pericardial component of the FAST examination is commonly used for patients who present with penetrating wounds to the precordium. In cases of concurrent lacerations of the pericardial sac, pericardial ultrasound may not detect a cardiac injury because of associated decompression into the thoracic cavity.
AB - Background: The pericardial window in a focused assessment with sonography for trauma (FAST) examination is highly accurate for detecting hemopericardium and, therefore, associated cardiac injury. A series of patients with false-negative pericardial ultrasound examinations, who were subsequently diagnosed with cardiac lacerations after presenting with stab wounds, are described. Methods: All patients with a normal pericardial ultrasound examination, despite subsequent diagnosis of a cardiac injury, are described (2005-2008). Results: Five patients with stab wounds to the precodium displayed initial and repeatedly normal pericardial windows on a FAST examination. Each patient was eventually diagnosed with a penetrating cardiac injury and concurrent laceration of their pericardial sac. This combination of injuries allowed decompression of blood from the cardiac injury into the thoracic cavity and, therefore, prevented accumulation of a hemopericardium. ConclusionS: The pericardial component of the FAST examination is commonly used for patients who present with penetrating wounds to the precordium. In cases of concurrent lacerations of the pericardial sac, pericardial ultrasound may not detect a cardiac injury because of associated decompression into the thoracic cavity.
KW - Cardiac
KW - Hemopericardium
KW - Penetrating
KW - Pericardial
KW - Tamponade
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=73649104092&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=73649104092&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e3181b16f30
DO - 10.1097/TA.0b013e3181b16f30
M3 - Article
C2 - 19901678
AN - SCOPUS:73649104092
VL - 67
SP - 1123
EP - 1124
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -