The use of computed tomography for penetrating heart injury screening.

retrospective transversal study which confronted tomographic findings with the ones detected in surgical exploration in patients that had undergone surgery because of suspected cardiac trauma from January, 2016 to January, 2018.

Results:

seventy-two cases were analysed; 97.2% of them were males, and the most prevalent age range was 20 to 29 years; 56.9% of them presented injuries caused by firearm shots and 43.1% by cutting weapons. In 20 cases, computed tomography suggested heart injury, confirmed in 13 cases during surgery. Sensitivity of computed tomography was 56.5%, reaching a specificity of 85.7%.

Conclusion:

computed tomography must not be adopted as a routine for the screening of penetrating heart injuries.

Keywords:
Heart; Wounds and Injuries; Heart Injuries; Tomography; Diagnosis

Sample characterization	n	(n=72)	p-value
Gender			<0.0001*
Female	2	2.8%
Male*	70	97.2%
Age range			0.0018**
<20	13	18.1%
20 to 29*	27	37.5%
30 to 39	16	22.2%
40 to 49	9	12.5%
≥50	7	9.7%

Heart injuries	Frequency	% (N=72)
Cardiac chamber
Injuried	17	23.6%
Uninjuried	55	76.4%
Site of the heart injury		n=17
Left ventricle	6	35.3%
Right ventricle	4	23.5%
Right and left ventricles	2	11.8%
Left atrium	2	11.8%
Right atrium	1	5.9%
Right and left atriums	1	5.9%
Intrapericardial vessel	1	5.9%

Exam performed	Cardiac Trauma
Exam performed	Presence		Abscence
Computed tomography (n=72)
Positive	13	18.1%	7	9.7%
Negative	10	13.9%	42	58.3%
Sensititivity: 56.5%; Specificity: 85.7%; PPV: 65%; NPV: 80.8%
Pericardial window (n=63)
Positive	15	23.8%	5	7.9%
Negative	0	0.0%	43	68.3%
Sensitivity: 100%; Specificity: 87.8%; PPV: 100%; NPV: 92.1%

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