A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium

Journal Article

2014

Permanent link to this Item
http://hdl.handle.net/11427/28238
Files
Nicol_Aarticle_2014.pdf (229.62 KB)
Authors
Nicol, Andrew John
Navsaria, Pradeep Harkison
Beningfield, Steve
Kahn, Delawir
Journal Title

World Journal of Surgery

Link to Journal
http://www.springer.com/medicine/surgery/journal/268
Journal ISSN
Volume Title
Publisher
Publisher

University of Cape Town

Department
Department of Psychiatry and Mental Health
Faculty
Faculty of Health Sciences
License
Series
Abstract
Background: Detection of a cardiac injury in a stable patient after a penetrating chest injury can be difficult. Ultrasound of the pericardial sac may be associated with a false negative result in the presence of a hemothorax. A filling in of the left heart border inferior to the pulmonary artery, called the straight left heart border (SLHB), is a radiological sign on chest X-ray that we have found to be associated with the finding of a hemopericardium at surgery. The aim of the present study was to determine if this was a reliable and reproducible sign. Methods: This was a prospective study of patients with a penetrating chest injury admitted between 1 October 2001 and 28 February 2009, who had no indication for immediate surgery, and were taken to the operating room for creation of a subxiphoid pericardial window (SPW). The chest X-ray was reviewed by a single trauma surgeon prior to surgery. Results: A total of 162 patients with a possible occult cardiac injury underwent creation of a SPW. Fifty-five of the 162 patients (34 %) were noted to have a SLHB on chest X-ray and a hemopericardium confirmed at SPW. The sensitivity of the SLHB sign was 40 %; specificity, 84 %; and positive predictive value, 89 %. (p = 0.005, Odds ratio 3.48, lower 1.41, upper 8.62). Conclusions: The straight left heart border is a newly described radiological sign that was highly significant in predicting the presence of a hemopericardium and should alert the clinician to a possible occult cardiac injury.
Description

Reference:

Nicol, A. J., Navsaria, P. H., Beningfield, S., & Kahn, D. (2014). A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium. World Journal of Surgery 2014, Volume 38, Issue 1, Pp 211-214, 38(1), 211-214. doi:10.1007/s00268-013-2242-z

Collections
Journal Articles