Traumatic ventricular septal defect following a stab wound to the chest

Abstract

A 51-year-old man who had been suffering from depression stabbed himself in the chest with an ice pick. At presentation, an ice pick lodged in the left fifth intercostal space was moving synchronously with his heartbeat. Echocardiography revealed that the tip was penetrating the anterior wall of the right ventricle. Because the patient was tamponading, an emergency operation was carried out. The ice pick was removed following the establishment of a cardiopulmonary bypass and pericardiotomy. The perforation of the right ventricle was closed with a pledget-reinforced mattress stitch. On postoperative day 12, a holosystolic murmur was detected on auscultation. Transthoracic echocardiography revealed a ventricular septal defect 5 mm in diameter located near the apex. The pulmonary-tosystemic flow ratio was 1.1 by echocardiographic measurement. No sign of heart failure was present. Although it was agreed to manage the ventricular septal defect conservatively, careful echocardiographic follow-up is mandatory.

Stroke Complicating Traumatic Ventricular Septal Defect

“…They can result from penetrating injury or blunt chest trauma (2,3). To our knowledge, stroke resulting from traumatic VSD has not been previously reported.…”

Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

“…2 Although the most common chamber involved in cardiac injuries is the right ventricle, it is clearly due to its anatomical location. 2 Although the most common chamber involved in cardiac injuries is the right ventricle, it is clearly due to its anatomical location.…”

“…2 Although the most common chamber involved in cardiac injuries is the right ventricle, it is clearly due to its anatomical location. [1][2][3][4][5][6] It has been postulated that the reason for the delay of VSP is due to a muscle spasm or a blood clot sealing the defect. 1 Table 1 shows that the time to reach a diagnosis of VSP ranges from 1 day to 10 years.…”

“…1 Diagnosis of ventricular septal perforation (VSP) could be delayed until the patient's clinical status improves. [1][2][3][4][5][6] It is important to repeat an echocardiography; however, computed tomography (CT) is also useful for anatomical detection. 1,4 We present a case of VSP with hematoma formation in the perforation site on an initial contrast CT.…”

How to mend a broken heart: a major stab wound of the left ventricle

“…In Norway, this type of injury is obviously less common but still existing [37-39]. Knife is the most common weapon for stab injuries, followed by other sharp items such as screwdrivers [34], ice picks [19], chopsticks, pneumatic nailgun nails [14,20,40] but also curiosities as barb from a sting ray [28]. Fractured ribs or sternum are also reported to cause cardiac penetration [41].…”