Skipper R, Debski R
Department of Surgery, Akron City Hospital, OH 44309.
J Trauma. 1990 Dec;30(12):1609-10. doi: 10.1097/00005373-199012000-00035.
The diagnosis of retained intracardiac missile is usually made at thoracotomy or fluoroscopy. Close inspection of plain chest X-rays may reveal blurring of radiopaque objects that are moving with the beating heart. In a gunshot wound victim who is initially stable, observation of this phenomenon should prompt a very high index of suspicion for cardiac injury. Invasive hemodynamic monitoring is indicated, and thoracotomy should be performed if penetrating cardiac injury is confirmed.
心内异物残留的诊断通常在开胸手术或透视检查时做出。仔细观察胸部平片可能会发现不透射线的物体随着心脏跳动而移动，影像模糊。对于最初情况稳定的枪伤受害者，观察到这种现象应高度怀疑心脏损伤。此时需进行有创血流动力学监测，若确诊为穿透性心脏损伤，则应行开胸手术。
