The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 510-518, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Late sequelae of penetrating cardiac wounds
JA Abbott, M Cousineau, M Cheitlin, AN Thomas and RC Lim Jr
Physiological and psychological parameters of 20 survivors of penetrating
wounds of the heart were examined 7 to 52 months after recovery. All
survivors had cardiac complaints. The psychological parameters for
hypochondriasis, compulsiveness, and internalization were much greater in
the patients than in control subjects but were similar to those in victims
of violent major abdominal trauma. Physiological abnormalities were present
in 19, although no particular pattern or abnormality could be related with
certainty to the type of wound, operative procedure, or postoperative
course. One recovered and re-employed victim required late surgical repair
of a traumatic ventricular septal defect and ventricular diverticulum.
Although functional work capacity measured by stress testing was normal in
90 percent, only eight survivors resumed employment. Complete
rehabilitation was impaired by a residual traumatic neurosis. Management
goals for patients with penetrating cardiac wounds should be broadened to
include prevention of psychological disabilities.
