Massive fatal ventricular septal defect due to nonpenetrating chest trauma in a six-year-old boy: The role of early invasive monitoring in an evolving lesion

Merzel, David I.; Stirling, Mack C.; Custer, Joseph R.

doi:10.1097/00006565-198509000-00007

Cited by 8 publications

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“…[2,5,11,12] The key to a favorable outcome is early suspicion of such a defect in the presence of heart failure following a period of relative cardiovascular stability. [4,10] Unfortunately, in our case, because of its rarity, the diagnosis of traumatic VSD was not initially suspected. Even when the diagnosis was eventually made, facilities and funds for urgent life-saving open-heart surgery were not readily available, as is the case in many resource-poor countries of the world.…”

Section: Discussionmentioning

confidence: 79%

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Acquired ventricular septal defect: A rare sequel of blunt chest trauma in a 7-year-old boy

et al. 2015

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Ventricular septal defect (VSD) is the most common congenital cardiac lesion encountered worldwide. Only very rarely is it acquired, and causation through blunt injury in a child is extremely rare. A previously healthy 7-year-old boy suffered blunt chest trauma while at play. He presented 11 days later with features of acute congestive cardiac failure. Two-dimensional echocardiographic examination revealed a mid-muscular VSD. The connection between the defect and the trauma was not initially appreciated. Facilities for required urgent open-heart surgery were not available. Cardiac failure was refractory to anti-failure therapy. His clinical condition steadily worsened, and he succumbed after 20 days on admission. We conclude that a diagnosis of traumatic VSD, though rare, should be considered in any previously well child presenting in acute congestive cardiac failure following blunt trauma to the chest. Any such patient should undergo careful echocardiographic evaluation. There is an urgent need for facilities for open-heart surgery to be more readily available and accessible in Nigeria.

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Section: Discussionmentioning

confidence: 79%

“…Isolated VSD is a rare result of blunt chest trauma [1][2][3] and is particularly rare in childhood. [4,5] Autopsy data suggests an incidence of approximately 1% for isolated VSD and approximately 5% for VSD associated with other cardiac injuries. [5] The authors are unaware of any previous report in a Nigerian child.…”

Section: Introductionmentioning

confidence: 99%

Acquired ventricular septal defect: A rare sequel of blunt chest trauma in a 7-year-old boy

et al. 2015

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Evolution of traumatically acquired infracristal ventricular septal defect

et al. 1993

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Ruptured interventricular septum after blunt chest trauma: Ultrasonographic diagnosis

et al. 1995

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A 6-year-old child was found under a heavy bookcase that compressed her chest. On admission to the emergency room she was found to be dyspneic with a systolic murmur and complete atrioventricular (A-V) block. Her condition deteriorated rapidly, leading to cardiogenic shock and loss of consciousness. Echocardiographic Doppler evaluation demonstrated a large ventricular septal defect and tricuspid insufficiency. A pericardial patch was put over the tear in the septum, and torn chordae tendinae were reimplanted to the papillary muscles. A pacemaker was inserted. Her situation improved, but on the third day cardiogenic shock and right ventricular dysfunction ensued and the patient expired. A review of the previous 13 cases from the pediatric literature is presented.

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Massive fatal ventricular septal defect due to nonpenetrating chest trauma in a six-year-old boy: The role of early invasive monitoring in an evolving lesion

Cited by 8 publications

References 0 publications

Acquired ventricular septal defect: A rare sequel of blunt chest trauma in a 7-year-old boy

Acquired ventricular septal defect: A rare sequel of blunt chest trauma in a 7-year-old boy

Evolution of traumatically acquired infracristal ventricular septal defect

Ruptured interventricular septum after blunt chest trauma: Ultrasonographic diagnosis

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