Traumatic ventricular septal defects

Williams, Gavin; Hara, Masauki; Bulloch, Robert T.

doi:10.1016/0002-9149(66)90439-5

Cited by 15 publications

(3 citation statements)

References 10 publications

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“…The first postulates that the rupture occurs due to acute compression of the heart between the sternum and the vertebrae during the late diastolic phase when the ventricles are filled and the atrioventricular valves are closed4). The second proposes that myocardial injury causes a microvascular disruption, leading to infarction and liquefaction of the septum5). In our case, the patient showed normal cardiac structure at the time of injury, but after 8 days, he was diagnosed as having a VSD, after repeated echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

et al. 2011

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Traumatic ventricular septal defect (VSD) resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

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Section: Discussionmentioning

confidence: 99%

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

et al. 2011

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“…Early mechanical rupture may occur when a sudden high pressure tears the ventricular septum at the end-diastole when the ventricles are filled and valves are closed [5]. Delayed inflammatory rupture may be caused by defective microcirculation associated with myocardial contusion, leading to necrosis and subsequent rupture of ventricular septum [6]. It is possible that early mechanical rupture causes sudden hemodynamic overload, whereas delayed inflammatory rupture causes gradual hemodynamic changes, leading to more frequent decompensation in patients diagnosed in the early phase.…”

Section: Case Presentationmentioning

confidence: 99%

Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report

Murakawa

Yoshida

Okada

et al. 2016

J Cardiothorac Surg

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BackgroundVentricular septal rupture (VSR) secondary to blunt chest trauma is rare and associated with a diverse range of symptoms and clinical courses as well as disease severity. We present a case of traumatic VSR in which rapid progression of heart failure was observed in spite of relatively low pulmonary to systemic blood flow (Qp/Qs) ratio.Case presentationA 40-year-old male was transported to the emergency department approximately 12 h after blunt chest trauma. VSR was diagnosed by echocardiography, and right heart catheterization revealed a Qp/Qs ratio of 1.52. Although medical treatment was initially attempted, subsequent rapid progression of heart failure necessitated emergent surgical repair of VSR.ConclusionsBecause small, asymptomatic VSR often close spontaneously, surgical repair of traumatic VSR is indicated when the shunt rate is relatively large or heart failure is present. However, the present case highlights the need to consider emergent surgical repair of traumatic VSR, even when the shunt rate is relatively small.

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“…The initial damage of the nutrient vessels of the septum or papillary muscles results in infarction which progresses to liquefaction necrosis and perforation or rupture (Williams and Bullock, 1961). 2.…”

Section: Pathology Of Traumatic Cardiac Lesions Thementioning

confidence: 99%

Mitral incompetence and ventricular septal defects following non-penetrating injury.

Anyanwu¹

1976

Thorax

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Traumatic ventricular septal defects

Cited by 15 publications

References 10 publications

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report

Mitral incompetence and ventricular septal defects following non-penetrating injury.

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