IMMEDIATE THORACOTOMY FOR A STAB WOUND OF THE HEART.

PENETRATING WOUNDS of the chest involving the heart may allow survival for a variable period of time after injury. In those wounds that are not rapidly fatal, a fairly uniform approach has evolved in which cardiac tamponade is treated by pericardial aspiration, and shock with blood transfusion.1-4Failure to respond to these measures, or recurring tamponade, requires a planned thoracotomy. Some have proposed a planned thoracotomy for all such wounds.5, 6 An occasional patient will survive long enough to get to a hospital but will die shortly thereafter. Such patients have not been included in treated series because of the overwhelming problems involved. The following case illustrates a problem in which an immediate thoracotomy in an emergency room a few minutes after admission was necessary and successful. Report of a Case A 27-year-old man was admitted to the emergency ward with a 3 cm stab wound in the