Heart damage

Heart damage divided into private and public (wounds).
Closed injuries can occur when you blow on the chest with a hard object or during a fall from a height. Heart damage can be of different nature: injury and concussion of the heart, break walls and valvular heart.
Clinically with closed injury of the heart pain can be observed in the region of heart rhythm abnormalities (premature beats, atrial fibrillation, bradycardia, partial or complete heart block), an increase of borders cardiac dullness, a drop in blood pressure. When the injury of heart clinical picture unfolds gradually. Violations of the cardiac activity are established by the ECG.
All cases of suspicious closed heart damage, subject to consultation with the doctor. Before the examination of the expert is necessary strict bed rest, strict observation of the colors of the heart and heart rate (bleeding in the pericardial cavity!). Every minor bleeding in the pericardium (see Emaperiod) the patient is transported with appropriate precautions in the surgical Department of the hospital, preferably specialized in.
Open injuries (wounds of the heart) in time of peace are usually cut or stab. In wartime are most often found gunshot wounds of the heart.
An expanded wound channel with wound of the heart there is abundant bleeding, quickly leading the patient to death. But not only bleeding from outer wounds causes the severity of the condition. When wounded heart even with narrow wound channel may have a strong internal bleeding into the cavity pleural or pericardial. Bleeding in the pericardial cavity quickly leads the patient to die due to compression of the heart streamed blood (tamponade heart).
Wounded in the heart quickly fall into a state of shock. Occurs sudden shortness of breath, pallor, and cyanosis of the skin, heart rate sharply Ochsen and weakened, often barely noticeable. If percussion borders of the heart are enlarged, the heart sounds are not defined. In some cases there is a presence of fluid in the pleural cavities.
When thoracoabdominal injuries observed simultaneous injury of the thoracic and abdominal cavities.
When providing first aid to the wounded in the heart of subcutaneously administered painkillers, on the wound of the thorax impose sterile dressing. Even if you suspect the injury to the heart introduction of heart and drugs increases the vascular tone (for example, adrenaline, ephedrine, strofantin, kordiamin, and others), is not suitable, as they can increase bleeding.

stitches for the wound of the heart
Fig. 3. Stitches for the wound of the heart.

Treatment of wounds of the heart can only be operational (no contraindications). The patient must be urgently taken to the operating room. The operation begins immediately once the patient will lay on the operating table. At the same time establish a system for intravenous blood, and prepare the way for intra-arterial injection of blood. The operation involves the exposure of the heart and the stitches on the wound of the heart (Fig. 3).
Before closing the wound of the heart is impractical to start a blood transfusion, if there is no risk of sudden cardiac arrest. Cardiac arrest is necessary fractional (100-200 ml) intra-arterial injection of blood to support the vital functions of the brain and the maintenance of vascular tone.
In the pleural cavity insert rubber drainage. The wound of the chest after primary surgical treatment and postoperative wound tightly sewn.