Cardiac wounds. Experience with 70 patients.

This study represents the personal experience of a general surgeon in 70 cases of penetrating injuries of the heart. Eighteen patients with no signs of life on admission were subjected to a thoracotomy on the stretcher with a mortality of 94%. Fifty-two patients were operated on in the operating theater with a mortality of 13.5%. Beck's triad (low blood pressure, raised central venous pressure, and distant cardiac sounds) was recorded in 77% of the cases with proven tamponade, but pulsus paradoxus in only 11%. In the author's opinion, percardiocentesis has no place in the diagnosis or treatment of cardiac injuries. Particular attention has been paid to the management of coronary artery injuries and the high incidence of air embolism in certain patients.