Delayed detection of a ventricular septal defect following penetrating trauma.

Abstract

This is a case report of a 27-year-old male who sustained a stab wound to the chest with a resulting penetrating cardiac injury and subsequent emergency thoracotomy. The patient survived his injury and on post-op day two, a holosystolic murmur was noted during physical exam, but he remained hemodynamically stable and intubated. A transthoracic echocardiogram revealed the presence of a ventricular septal defect (VSD), with Doppler flow revealing shunting from the left ventricular cavity into the right ventricular cavity. Ultimately, the clinicians decided upon a trial of extubation with a plan for delayed closure of the VSD. Upon extubation,the patient became hypoxemic with evidence of pulmonary edema; thus, he was re-intubated. The defect was surgically repaired, and the patient had an uneventful recovery thereafter. The purpose of this case report is to present an example of delayed detection of a ventricular septal defect after a penetrating cardiac injury.

• Authors: Terrell Caffery, Danny Robinson, Hollis O'Neal, Azheem Kahn, Scott Thurston, Mandi Musso
• Journal: The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society (J La State Med Soc) 2014 Nov-Dec Vol. 166 Issue 6 Pg. 239-41 ISSN: 0024-6921 [Print] United States
• PMID: 25978659 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Echocardiography
• Heart Injuries (surgery)
• Heart Septal Defects, Ventricular (diagnostic imaging, surgery)
• Humans
• Male
• Thoracotomy
• Treatment Outcome
• Wounds, Stab (surgery)