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

BACKGROUND: Ventricular septal perforation (VSP) can be caused by a penetrating cardiac injury. Diagnosis of VSP tends to be delayed because a shunt might not be detected by color flow Doppler at an early stage following injury. CASE PRESENTATION: A 60‐year‐old man with depression was admitted to th...

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Detalles Bibliográficos
Autores principales: Shioya, Nobuki, Inoue, Nozomu, Muto, Harutatsu, Tomita, Akiko, Tsukamoto, Yuki, Kawashima, Naonori, Hazama, Koji, Shichinohe, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Case Reports
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603320/
https://www.ncbi.nlm.nih.gov/pubmed/31304038
http://dx.doi.org/10.1002/ams2.419
Descripción
Sumario:BACKGROUND: Ventricular septal perforation (VSP) can be caused by a penetrating cardiac injury. Diagnosis of VSP tends to be delayed because a shunt might not be detected by color flow Doppler at an early stage following injury. CASE PRESENTATION: A 60‐year‐old man with depression was admitted to the emergency center after a knife injury in the chest. A focused assessment with sonography for trauma revealed cardiac tamponade. Shortly after an open cardiac massage and a pericardiotomy, his spontaneous circulation returned. At a later stage, follow‐up computed tomography, echocardiography, and left ventriculography showed traumatic ventricular septal perforation. Conservative therapy was chosen because the pulmonary blood flow/systemic blood flow ratio was 1.42. CONCLUSION: The initial contrast computed tomography shows a septal hematoma. Its presence could be perceived as a perforation site in the interventricular septum.

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