ABSTRACT

In the past, penetrating trauma were seen more frequently. However, due to the increasing social violence as a result of industrial development, sociocultural differentiation and problems have caused significant and progressive increases in gun-shot wounds and high-energy traffic accidents. Cardiac trauma constitute 10% of all thoracic trauma; however, they are responsible for 40% of mortality in these cases. Cardiac traumas may occur in any part of the heart and they are classified as blunt, penetrating and iatrogenic, according to the occurrence of the trauma. Penetrating trauma are less frequent but they are significant as they require prompt diagnosis and treatment. The clinical picture of the blunt or penetrating cardiac trauma admitted to the emergency unit includes a wide spectrum, ranging from myocardial contusion to cardiac rupture. Cases may have no signs of life or may be agonal, hypotensive or relatively stable. Mortality due to penetrating or blunt cardiac trauma usually occurs before the patients are admitted to a hospital. Prompt clinical evaluation and appropriate systemic perfusion must be ensured in this variable clinical spectrum of patients that have cardiac trauma. Cardiac trauma cases require a multidisciplinary approach and in the diagnosis and treatment of these cases, the presence of an anesthesiologist, ensuring proper airway, adequate ventilation and adequate volume replacement are the key factors. (JAREM 2012; 2: 20-3)

Keywords: Cardiac trauma, anesthesia, penetrating cardiac injury, blunt cardiac injury, tamponade, echocardiography