title: 'Missed stabbed hearts'--pitfalls in the diagnosis of penetrating cardiac injuries. Report of 4 cases.
abstract: Classically, penetrating injuries of the heart present with clinical signs of an ongoing massive haemorrhage or cardiac tamponade. In a few patients, however, none of these signs are present and the diagnosis is overlooked. Diagnostic aids, such as ultrasonography or angiography, are occasionally misleading. Four cases of penetrating cardiac injuries that were not diagnosed on initial presentation, but which subsequently manifested with a secondary and sometimes fatal haemorrhage, are presented. Recommendations are made for preventing diagnostic delays.
authors.affiliation: Department of Surgery, Hillbrow Hospital, Johannesburg.
authors.forename: J A
authors.initials: JA
authors.lastname: Mayor-Davies
authors.forename: A
authors.initials: A
authors.lastname: D'Egidio
authors.forename: M
authors.initials: M
authors.lastname: Schein
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis*; D006801:Humans; D008297:Male; D014951:Wounds, Stab / Q000175:diagnosis*