Thorac Cardiovasc Surg 2008; 56(4): 231-232
DOI: 10.1055/s-2007-989282
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© Georg Thieme Verlag KG Stuttgart · New York

Nonlethal Penetrating Cardiac Injury from a Hammer Splinter

F. Santini1 , L. Barozzi1 , G. Faggian1 , A. Mazzucco1
  • 1Division of Cardiac Surgery, University of Verona, Verona, Italy
Further Information

Publication History

Received July 19, 2007

Publication Date:
15 May 2008 (online)


Based on the patient's vital signs, the presence of cardiac tamponade, and/or hemorragic shock on admission, penetrating cardiac injuries can be divided into four clinical types. In type 1, the pericardial wounds are small and the patients have signs of cardiac tamponade. In type 2, the pericardial wounds are large and the patients may be in severe shock associated with massive hemothorax. Cardiac tamponade and hemorrhagic shock are present concomitantly in type 3. Patients with type 4 injury are rather rare and have neither cardiac tamponade nor hemorrhagic shock, as is the case when cardiac damage is mild with some little bleeding [[1]].

These latter cases can be surprisingly challenging because the paucity of clinical signs and symptoms can delay diagnosis and treatment, with potentially dreadful consequences [[2]].


Dr. MD Francesco Santini

Division of Cardiac Surgery
University of Verona

Piazzale Stefani 1

37126 Verona


Phone: + 39 (0) 4 58 12 24 76

Fax: + 39 (0) 4 58 12 33 08