Trauma to the heart: A review of presentation, diagnosis, and treatment.

Cardiac injury remains a rare occurrence even to the most experienced trauma surgeon. Despite this rarity, a physician receiving trauma patients with potential injury to the heart must be prepared to lead a rapid and precise assessment, request the relevant diagnostic imaging, and guide a surgical or observation based plan. A high index of suspicion of cardiac injury is vital to avoid missed injuries and preventable fatalities. Knowledge of the differences between blunt and penetrating cardiac trauma is crucial in managing these patients. A paucity of data has prevented evidenced based guidelines, nevertheless large volume centers continue to publish and update their experiences which have led to recommendations on how to evaluated and treat cardiac trauma patients with good outcomes. This paper reviews the literature on cardiac trauma, while focusing on the difference between blunt and penetrating injury, the current recommendations for diagnostic imaging, observation, and certain principles of surgical treatments.