title: Effect of cardiac stabbing on ventricular function: evaluation by radionuclide angiography.
abstract: OBJECTIVE
  To determine whether cardiac stab wounds cause early ventricular dysfunction.
  
  
  METHODS
  Retrospective case series over 7 years.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  Nine consecutive survivors of cardiac stab wounds.
  
  
  METHODS
  Postoperative radionuclide angiography performed in all patients between 1 and 13 days after injury.
  
  
  METHODS
  Information on the patient's clinical presentation and hospital course was obtained from the patient's charts and correlated with ventricular function as measured by the right and left ventricular ejection fractions (RVEF and LVEF).
  
  
  RESULTS
  Cardiac injuries consisted of isolated right (five) and left (three) ventricular lacerations, and one biventricular laceration. Three patients had perioperative dysrhythmias (two ventricular, one atrial), and nonspecific electrocardiographic changes occurred in seven patients. Six patients had postoperative complications: pericarditis in three and pneumonia, pulmonary thromboembolism and abdominal wound dehiscence in one each. The LVEF was normal in all patients. Although none had clinically apparent cardiac dysfunction at the time of radionuclide angiography, six patients had a reduced RVEF (less than 0.45). All patients remained asymptomatic at the time of discharge from hospital (median 12 days postoperatively). In two of the six patients who had a reduced RVEF, one had a normal RVEF 2 months later; the other had a near-normal RVEF (0.43) but had persistent right ventricular enlargement 7 months later. Both were asymptomatic.
  
  
  CONCLUSIONS
  Although a reduced RVEF is common in survivors of cardiac stab wounds, the reduction is small and is not associated with clinically apparent cardiac dysfunction.
authors.affiliation: Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver.
authors.forename: E D
authors.initials: ED
authors.lastname: Skarsgard
authors.forename: P T
authors.initials: PT
authors.lastname: Phang
authors.forename: A S
authors.initials: AS
authors.lastname: Belzberg
authors.forename: J A
authors.initials: JA
authors.lastname: Russell
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011875:Radionuclide Angiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016276:Ventricular Function / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology; D014951:Wounds, Stab / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery