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

BACKGROUND: Ventricular 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 lo...

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Autores principales: Murakawa, Kosuke, Yoshida, Susumu, Okada, Takayuki, Toyoshima, Chie, Yuyama, Reisuke, Minato, Naoki, Shiojima, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828874/
https://www.ncbi.nlm.nih.gov/pubmed/27068402
http://dx.doi.org/10.1186/s13019-016-0457-4
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author Murakawa, Kosuke
Yoshida, Susumu
Okada, Takayuki
Toyoshima, Chie
Yuyama, Reisuke
Minato, Naoki
Shiojima, Ichiro
author_facet Murakawa, Kosuke
Yoshida, Susumu
Okada, Takayuki
Toyoshima, Chie
Yuyama, Reisuke
Minato, Naoki
Shiojima, Ichiro
author_sort Murakawa, Kosuke
collection PubMed
description BACKGROUND: Ventricular 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 PRESENTATION: A 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. CONCLUSIONS: Because 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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spelling pubmed-48288742016-04-13 Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report Murakawa, Kosuke Yoshida, Susumu Okada, Takayuki Toyoshima, Chie Yuyama, Reisuke Minato, Naoki Shiojima, Ichiro J Cardiothorac Surg Case Report BACKGROUND: Ventricular 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 PRESENTATION: A 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. CONCLUSIONS: Because 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. BioMed Central 2016-04-12 /pmc/articles/PMC4828874/ /pubmed/27068402 http://dx.doi.org/10.1186/s13019-016-0457-4 Text en © Murakawa et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Murakawa, Kosuke
Yoshida, Susumu
Okada, Takayuki
Toyoshima, Chie
Yuyama, Reisuke
Minato, Naoki
Shiojima, Ichiro
Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title_full Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title_fullStr Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title_full_unstemmed Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title_short Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report
title_sort traumatic ventricular septal rupture associated with rapid progression of heart failure despite low qp/qs ratio: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828874/
https://www.ncbi.nlm.nih.gov/pubmed/27068402
http://dx.doi.org/10.1186/s13019-016-0457-4
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