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The J wave may be useful in the subset of patients where the ultrasound is negative for pericardial fluid, and there is an associated haemothorax. J waves were present in 6/14 (43%) of this subset of patients who had a hemopericardium later diagnosed at SPW. It is interesting to note that in 6 patients, a J wave was present [http://www.selleckchem.com/products/AG-014699.html Rucaparib manufacturer] and the US detected pericardial fluid but yet the surgical exploration was negative. Three of these 6 patients had an associated pneumopericardium and it may be that the presence of air, as well as blood, in the pericardial sac may contribute to this electrographic finding. There is very little data on the role of CT scanning in screening for a cardiac injury in stable patients with a penetrating chest injury. Nagy et al. published a retrospective study in 1996 on the accuracy of CT to diagnose a cardiac injury in 60 patients that presented [https://en.wikipedia.org/wiki/ALPI ALPI] stable [45]. The CT scan was able to exclude a cardiac injury in 56 and these patients were discharged home after 24-h without any surgery. One patient had an equivocal CT for pericardial fluid and three patients had fluid confirmed on CT. All four patients had a subxiphoid pericardial window and this was positive in only two patients with a confirmed cardiac injury. In the other two patients the SPW was negative. The sensitivity and specificity of CT scan was reported as being 100%, and 96.6% respectively, but a major problem in this study was the fact that there were only two positive cardiac injuries. There have been no prospective studies on the role of CT. The question still remains how CT should be used in screening particularly in view of the fact that the majority of patients are young and the radiation dose is significant? Another issue [http://www.selleckchem.com/products/otx015.html OTX015] also is the movement of a patient to the scanner, the resource availability and the fact that an ultrasound is generally more frequently available in the emergency department. This study clearly demonstrates that the presence of a J waves indicates a significant risk of a hemopericardium being present after penetrating thoracic trauma. The sensitivity is low at 43.7% but with a specificity of 84.6% (p?