Document resource
Penetrating cardiac injury remains one of the most lethal injuries, with over 80% mortality, and the majority of deaths occurring before hospital arrival.1 Mendlola Pla and colleagues offer an 8-year, single-center analysis of 57 penetrating cardiac injuries.2 Their central message is clear: survival hinges less on the cardiac wound alone than on mechanism, physiology, and injury burden. Gunshot wounds, multichamber injuries, associated thoracic vascular injury, concurrent abdominal trauma, and arrest prior to arrival all portend poor outcomes,1 2 whereas stab wounds, preserved arrival physiology, and isolated cardiac injury remain the strongest signals for survival—findings that reinforce the existing literature.1 3 4