Delayed detection of a ventricular septal defect following penetrating trauma
Caffery, T.; Robinson, D.; O'Neal, H.; Kahn, A.; Thurston, S.; Musso, M.
Journal of the Louisiana State Medical Society Official Organ of the Louisiana State Medical Society 166(6): 239-241
2014
ISSN/ISBN: 0024-6921 PMID: 25978659 Document Number: 674492
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.