Duque H A, Florez L E, Moreno A, Jurado H, Jaramillo C J, Restrepo M C
Department of Surgery, University of Antioquia, San Vicente de Paul University Hospital, Medellín, Antioquia, Colombia, 14.
World J Surg. 1999 Dec;23(12):1254-7. doi: 10.1007/s002689900658.
A prospective study was carried out to analyze the evolution of patients who survived penetrating cardiac trauma. A total of 642 patients were evaluated. A 1-year follow-up, which included physical examinations, electrocardiography, echocardiography and stress tests, was completed in 192 patients. Data processing included calculation of average and percentage values. At follow-up, 90% of patients were asymptomatic at 2 days after surgery, with normal cardiac monitoring; baseline and control ECGs showed myocardial infarction in 9.1% of patients. Baseline ECGs showed pericarditis as well in 27% of patients and repolarization changes in 35.2%. The latter became normal within 1 to 6 months after the trauma. All (100%) of the patients had a functional status I stress test, and 56% had a normal echocardiography. In conclusion, the epidemiologic behavior of penetrating cardiac trauma is identical to that of general trauma. ECG is useful during the postsurgery period for diagnosis of traumatic myocardial infarction. Likewise, the stress test is useful in patients with myocardial infarction and echocardiography in the presence of either myocardial infarction or any symptom suggesting anatomic or functional alterations of the heart.
开展了一项前瞻性研究，以分析穿透性心脏创伤存活患者的病情演变。共评估了642例患者。192例患者完成了为期1年的随访，包括体格检查、心电图、超声心动图和负荷试验。数据处理包括计算平均值和百分比值。随访时，90%的患者术后2天无症状，心脏监测正常；基线心电图和对照心电图显示9.1%的患者发生心肌梗死。基线心电图还显示27%的患者患有心包炎，35.2%的患者有复极改变。后者在创伤后1至6个月内恢复正常。所有（100%）患者的负荷试验功能状态为I级，56%的患者超声心动图正常。总之，穿透性心脏创伤的流行病学行为与一般创伤相同。心电图在术后诊断创伤性心肌梗死时很有用。同样，负荷试验对心肌梗死患者有用，超声心动图对存在心肌梗死或任何提示心脏解剖或功能改变症状的患者有用。
