A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds.

Chad G. Ball, Brian H. Williams, Amy D. Wyrzykowski, Jeffrey M. Nicholas, Grace S. Rozycki, David V. Feliciano

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)1123-1124
Number of pages2
JournalThe Journal of trauma
Volume67
Issue number5
StatePublished - Nov 2009

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Penetrating Wounds
Wounds and Injuries
Lacerations
Stab Wounds
Thoracic Cavity
Ultrasonography
Pericardial Effusion
Pericardium
Decompression

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ball, C. G., Williams, B. H., Wyrzykowski, A. D., Nicholas, J. M., Rozycki, G. S., & Feliciano, D. V. (2009). A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. The Journal of trauma, 67(5), 1123-1124.

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 S.; Feliciano, David V.

In: The Journal of trauma, Vol. 67, No. 5, 11.2009, p. 1123-1124.

Research output: Contribution to journalArticle

Ball, CG, Williams, BH, Wyrzykowski, AD, Nicholas, JM, Rozycki, GS & Feliciano, DV 2009, 'A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds.', The Journal of trauma, vol. 67, no. 5, pp. 1123-1124.
Ball CG, Williams BH, Wyrzykowski AD, Nicholas JM, Rozycki GS, Feliciano DV. A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. The Journal of trauma. 2009 Nov;67(5):1123-1124.
Ball, Chad G. ; Williams, Brian H. ; Wyrzykowski, Amy D. ; Nicholas, Jeffrey M. ; Rozycki, Grace S. ; Feliciano, David V. / A caveat to the performance of pericardial ultrasound in patients with penetrating cardiac wounds. In: The Journal of trauma. 2009 ; Vol. 67, No. 5. pp. 1123-1124.
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AU - Feliciano, David V.

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