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Late sequelae of penetrating cardiac injuries
D Demetriades1, C Charalambides, P Sareli
1Department of Surgery and Medicine, Baragwanath Hospital, Johannesburg, South Africa.
Insights
Survivors of penetrating cardiac injuries frequently experience late cardiac complications. Routine echocardiograms are recommended for follow-up assessment of these high-incidence sequelae.
Area of Science:
- Cardiology
- Trauma Surgery
- Cardiovascular Imaging
Background:
- Penetrating cardiac injuries can lead to significant morbidity.
- Long-term outcomes and potential late cardiac complications in survivors are not fully understood.
Purpose of the Study:
- To assess the incidence and types of late cardiac complications in patients who survived penetrating cardiac injuries.
- To evaluate the utility of routine follow-up assessments, including echocardiography.
Main Methods:
- Retrospective analysis of 54 patients surviving penetrating cardiac injury.
- Mean follow-up duration of 23 months post-injury.
- Clinical evaluation, electrocardiography (ECG), and two-dimensional Doppler echocardiography were utilized.
Main Results:
- Clinical assessment suggested complications in 17% of patients.
- Electrocardiogram abnormalities were noted in 31%, though often non-diagnostic.
- Echocardiography revealed abnormalities in 31%, including valvular/septal defects (19%), pericardial effusion, and ventricular dysfunction.
Conclusions:
- Late cardiac sequelae following penetrating cardiac injury appear to be common.
- Routine follow-up, incorporating echocardiography, is crucial for identifying these complications.
- Further investigation is needed to definitively attribute all observed abnormalities to the initial trauma.
Abstract:
Fifty-four patients who survived a penetrating cardiac injury were assessed for late cardiac complications. The mean follow-up after injury was 23 months. Clinical history and physical examination suggested cardiac complications in nine patients (17 per cent). Electrocardiogram was abnormal, but usually not diagnostic, in 17 (31 per cent). Routine two dimensional Doppler echocardiography revealed abnormalities in 17 (31 per cent). Ten patients (19 per cent) had valvular or septal defects. Other abnormalities included pericardial effusion, ventricular and septal dysfunction, and ventricular dilatation. Although it is impossible to determine how many of these abnormalities were post-traumatic, it seems that the incidence of late sequelae of cardiac injuries is high, and it is recommended that routine late follow-up of these patients should be done. Assessment should include routine echocardiograms.