A large ventricular septal defect complicating resuscitation after blunt trauma

A large ventricular septal defect complicating resuscitation after blunt trauma

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A young adult pedestrian was admitted to hospital after being hit by a car.On arrival to the Accident and Emergency Department, the patient read more was tachycardic, hypotensive, hypoxic, and acidotic with a Glasgow Coma Scale of 3.Despite initial interventions, the patient remained persistently hypotensive.An echocardiogram demonstrated a traumatic ventricular septal defect (VSD) with right ventricular strain and increased pulmonary artery pressure.Following a period of stabilization, open cardiothoracic surgery was performed and revealed an aneurysmal septum with a single large defect.

This was repaired with a bovine patch, resulting in normalization of right ventricular function.This case provides a vivid depiction puffy spa headband of a large VSD in a patient following blunt chest trauma with hemodynamic compromise.In all thoracic trauma patients, and particularly those poorly responsive to resuscitation, VSDs should be considered.Relevant investigations and management strategies are discussed.