Journal of Emergencies, Trauma, and Shock
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Year : 2012  |  Volume : 5  |  Issue : 2  |  Page : 184-187

Ventricular septal defect following blunt chest trauma

1 Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
2 Department of Trauma and Critical Care, Inkosi Albert Luthuli Hospital, Durban, KwaZulu-Natal, South Africa
3 Department of Anaesthetics, Perioperative Research Group and Outcomes Research Consortium, Cleveland, Ohio, Canada

Correspondence Address:
Lisa Ryan
Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal
South Africa
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Source of Support: Dr. Rodseth is supported by a CIHR Scholarship (the Canada-HOPE Scholarship), the College of Medicine of South Africa (the Phyllis Kocker/Bradlow Award), and the University of KwaZulu-Natal (competitive research grant), Conflict of Interest: None

DOI: 10.4103/0974-2700.96492

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We present a 32-year-old male with ventricular septal defect (VSD) following blunt chest trauma. Traumatic VSD is a rare but potentially life-threatening injury, the severity, course and presentation of which are variable. While the diagnosis of myocardial injury may be challenging, cardiac troponins are useful as a screening and diagnostic test. The proposed pathophysiological mechanisms in the development of traumatic VSD are early mechanical rupture and delayed inflammatory rupture. We conducted a literature review to investigate the pathogenesis, distribution of patterns of presentation, and the associated prognoses in patients with VSD following blunt chest trauma. We found that traumatic VSDs diagnosed within 48 hours were more likely to be severe, require emergency surgery and were associated with a higher mortality. Children with traumatic VSDs had an increased mortality risk. Smaller lesions may be managed conservatively but should be followed up to detect late complications. In both groups elective repair was associated with a good outcome.

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