Multiple penetrating injuries to the heart diagnosed with ultrasonography.

Penetrating heart injury poses significant diagnostic and therapeutic challenges. Patients may initially appear in extremis or in stable condition. Surgeon-performed ultrasonography is effective in determining the presence or absence of tamponade. Definitive repair requires cardiorrhaphy, using a median sternotomy or thoracotomy incision, depending on the suspected injury site(s). Frequent postoperative complications can usually be managed without reoperation. Echocardiography, electrocardiography, and cardiac catheterization may be used postoperatively in reassessment. A patient with stab wounds to both ventricles of the heart is described.