[Stab injuries of the heart].

Stab injuries of the heart belong into the category of fatal injuries. Along with the increased crime rate also the number of these injuries increased and they must be tackled unexpectedly by the surgeon who frequently lacks specialization in cardiosurgery. The authors present the case histories of three patients whom they treated successfully in 2001. All there were males, at the time of admission to the emergency department with marginal stabilization of the circulation. Ultrasound examination of the pericardium revealed in all a haemopericardium with amounts from 150 to 300 ml, one man was operated already with symptoms of progressing tamponade of the pericardium. During surgical revision in the operation theatre always one isolated injury of one of the cardiac departments was treated. The postoperative course was uncomplicated and the patients were discharged into domiciliary care on the 7th and 8th day after surgery resp. Consistent with quoted authors, favourable prognostic factors in penetrating stab wounds of the heart include the following: younger age, early transport to the emergency centre, presence of cardiac tamponade and early surgical revision by a competent surgeon without the necessity of specialization in cardiosurgery. The authors emphasize the rule which pushes examination methods into the background: stab wound in the cardiac area + unstable circulation = surgical revision.