The heart is under the lower third of the sternum. Implications for external cardiac massage
D. A. Finholt, R. G. Kettrick, H. R. Wagner and D. B. Swedlow
Current guidelines for cardiopulmonary resuscitation in children state that
the heart lies under the midsternum in infancy and descends with age. To
verify this statement, we studied 55 patients, aged 1 day to 19 years,
including eight premature infants, during either routine chest x-ray films
or right-sided heart angiography. Using a Cartesian coordinate system
determined by radiopaque markers placed on the chest, and computer
digitization, we located the center of each patient's cardiac silhouette
and/or right ventricle. Using descriptive statistics, we found that the
heart lay under the lower third of the sternum in all age groups. Analysis
of variance indicated that there was no significant difference in this
location between age groups. These results suggest that recommendations for
external cardiac massage in infants and children may need to be revised.
