[Injuries of the heart--diagnosis and therapy]

Injuries of the heart are present in 7-12% of all thoracic trauma cases. Most of these (80%) are polytrauma patients. The mechanism of the accident, the localisation of injuries, the physical condition of the patients and the skills of the hospital stuff are determinant factors for the outcome. Hemodynamic instability needs an urgent echocardiography, signs of an obstructive pericardial hematoma and/or progressive bleeding require an urgent operation using a left lateral or mediosternal approach. ECC and cell saving should be available. The contusion of the heart is monitored by ECG and Troponin tests. The application of a "mini" heart-lung machine in difficult situations could be very useful.