Table 1. Heart Injury Scale.
| Grade* | Description of Injury | AIS code | AIS code modification |
|---|---|---|---|
| I | Blunt cardiac injury with minor ECG abnormality (nonspecific ST or T wave changes, premature arterial or ventricular contraction or persistent sinus tachycardia) | 441099.3 | 441099.1 |
| Blunt or penetrating pericardial wound with out cardiac injury, cardiac tamponade, or cardiac herniation | 441002.3 | 441002.1 | |
| 441004.3 | 441004.1 | ||
| II | Blunt cardiac injury with heart block (right or left bundle branch, left anterior fascicular, or atrioventricular) or ischemic changes (ST depression or T wave inversion) without cardiac failure | 441699.2 | |
| Penetrating tangential myocardial wound up to, but not extending through endocardium, without tamponade | 441602.2 | ||
| III | Blunt cardiac injury with sustained (>6 beats/min) or multilocal ventricular contractions | 441008.3 | |
| Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion without cardiac failure | 441010.3 | ||
| Blunt pericardial laceration with cardiac herniation | 441604.3 | ||
| Blunt cardiac injury with cardiac failure | |||
| Penetrating tangential myocardial wound up to, but extending through, endocardium, with tamponade | |||
| IV | Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion producing cardiac failure | 441006.4 | |
| Blunt or penetrating cardiac injury with aortic mitral valve incompetence | |||
| Blunt or penetrating cardiac injury of the right ventricle, right atrium, or left atrium | |||
| V | Blunt or penetrating cardiac injury with proximal coronary arterial occlusion | 440400.5 | |
| Blunt or penetrating left ventricular perforation | 441012.5 | ||
| Stellate wound with < 50% tissue loss of the right ventricle, right atrium, or of left atrium | 441606.5 | ||
| VI | Blunt avulsion of the heart; penetrating wound producing > 50% tissue loss of a chamber | 441018.6 |
Scaling system for heart injuries, as described by Moore et al. [22]. Correlation to the Abbreviated Injury Score (AIS) 2005 is given. To account for the recommendation of Mattox et al. [21], minor blunt injury was scaled down (see AIS modification).
*Advance one group for multiple wounds to a single chamber or multiple chamber involvement.