Penetrating cardiac injury with urgent not emergent thoracotomy

This report describes a 22-year-old male who presented with penetrating trauma to the left second intercostal space. He was found to be clinically stable; however, Focused Assessment with Sonogrpahy in Trauma (FAST) exam revealed large pericardial effusion suspicious for cardiac injury. Management of the patient with penetrating trauma to the chest is discussed and appropriate literature is reviewed. This report supports delayed thoracotomy in the appropriately selected patient as safe. It avoids the morbidity and unnecessary dangers incumbent in emergency department (ED) thoracotomy.