A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium
| dc.contributor.author | Nicol, Andrew John | |
| dc.contributor.author | Navsaria, Pradeep Harkison | |
| dc.contributor.author | Beningfield, Steve | |
| dc.contributor.author | Kahn, Delawir | |
| dc.date.accessioned | 2018-06-06T13:23:57Z | |
| dc.date.available | 2018-06-06T13:23:57Z | |
| dc.date.issued | 2014 | |
| dc.date.updated | 2016-01-13T13:16:35Z | |
| dc.description.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. | |
| dc.identifier | http://dx.doi.org/10.1007/s00268-013-2242-z | |
| dc.identifier.apacitation | Nicol, A. J., Navsaria, P. H., Beningfield, S., & Kahn, D. (2014). A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium. <i>World Journal of Surgery</i>, http://hdl.handle.net/11427/28238 | en_ZA |
| dc.identifier.chicagocitation | Nicol, Andrew John, Pradeep Harkison Navsaria, Steve Beningfield, and Delawir Kahn "A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium." <i>World Journal of Surgery</i> (2014) http://hdl.handle.net/11427/28238 | en_ZA |
| dc.identifier.citation | 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 | |
| dc.identifier.ris | TY - AU - Nicol, Andrew John AU - Navsaria, Pradeep Harkison AU - Beningfield, Steve AU - Kahn, Delawir AB - 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. DA - 2014 DB - OpenUCT DP - University of Cape Town J1 - World Journal of Surgery LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium TI - A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium UR - http://hdl.handle.net/11427/28238 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/28238 | |
| dc.identifier.vancouvercitation | Nicol AJ, Navsaria PH, Beningfield S, Kahn D. A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium. World Journal of Surgery. 2014; http://hdl.handle.net/11427/28238. | en_ZA |
| dc.language.iso | eng | |
| dc.publisher.department | Department of Psychiatry and Mental Health | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.source | World Journal of Surgery | |
| dc.source.uri | http://www.springer.com/medicine/surgery/journal/268 | |
| dc.title | A Straight Left Heart Border: A New Radiological Sign of a Hemopericardium | |
| dc.type | Journal Article | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |