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Left atrium
4%
8/222
Left ventricle
18%
40/222
Right atrium
2%
5/222
Right ventricle
72%
160/222
Aorta
4/222
Select Answer to see Preferred Response
The right ventricle sits in the most anterior position in the thorax. A penetrating trauma to the chest, specifically at the left 4th intercostal space at the sternocostal junction, is likely to result in injury to the right ventricle first. Hemodynamic instability following penetrating trauma to the chest raises the possibility of injury to cardiovascular structures. Evaluation of a trauma patient requires careful attention to the underlying anatomical structures that may be affected by a particular injury. Because the right ventricle is situated anteriorly, it is the most likely structure to be injured in a stab wound such as that seen in this vignette. Incorrect Answers: Answer 1: The LA is the most posterior part of the heart and would not be affected first by the stab wound. Answer 2: The LV is situated posterior to the right ventricle and would be the first to be involved if the injury were more lateral on the chest. Answer 3: The RA is situated in the right thorax and would be unaffected by the stab wound. Answer 5: The aorta would be the most posterior structure of the listed answer choices and would not be affected first.
3.2
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