PENETRATING CARDIAC INJURIES

El corazon es un loco que no sabe de un color: O es su amor de dos colores, O dice que no hay Amor. The Heart is a madman, That does not recognize a single color: Either his love is of two colors, Or he declares that there is no love. JOSE MARTI, Cuban Poet and Liberator The heart is such a unique organ, so vital and constant in its tireless function, yet so fickle once its never-ending musical rhythms are disturbed. It is never the tired worker, the strong beating never ceasing, yet so romantic in its very reason for existing. No other organ has inspired so many talented poets, writers, and musicians to create sweet and endless poems, alluring novels, and beautiful rhythms. Witness Homer's poetic description of the death of Sarpedon from the classical Greek epic The Iliad 67 : Not so Patroclus' never erring darts; Aim'd at his breast, it peers at the mortal part, Where the strong fibers bind the solid heart. Th'insulting Victor with disdain bestrode The prostrate prince, and on his bosom trod; Then drew the weapon from his panting heart, The reaking fibers clinging to the dart; From the wide wound gush'd out a stream of blood, And the soul issued in a purple flood. The purpose of this article is to cover in detail all aspects of cardiac injury management, including the controversies generated by the newer diagnostic modalities such as echocardiography versus the gold standard represented by the subxiphoid pericardial window. This article also examines in great detail the topic of emergency department (ED) thoracotomy, along with the technical complexities of the surgical management of these challenging injuries.