Journal of Emergencies, Trauma, and Shock

CASE REPORT
Year
: 2012  |  Volume : 5  |  Issue : 4  |  Page : 350--352

A large ventricular septal defect complicating resuscitation after blunt trauma


Henry D I De'Ath1, Paul E D Vulliamy1, Ceri Davies2, Rakesh Uppal2 
1 Trauma Clinical and Academic Unit, The Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom
2 Heart and Chest Centre, London Chest Hospital, Bonner Road, London, E2 2JX, United Kingdom

Correspondence Address:
Henry D I De«SQ»Ath
Trauma Clinical and Academic Unit, The Royal London Hospital, Whitechapel, London, E1 1BB,
United Kingdom

A young adult pedestrian was admitted to hospital after being hit by a car. On arrival to the Accident and Emergency Department, the patient 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 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.


How to cite this article:
De'Ath HD, Vulliamy PE, Davies C, Uppal R. A large ventricular septal defect complicating resuscitation after blunt trauma.J Emerg Trauma Shock 2012;5:350-352


How to cite this URL:
De'Ath HD, Vulliamy PE, Davies C, Uppal R. A large ventricular septal defect complicating resuscitation after blunt trauma. J Emerg Trauma Shock [serial online] 2012 [cited 2020 Jun 1 ];5:350-352
Available from: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2012;volume=5;issue=4;spage=350;epage=352;aulast=De%27Ath;type=0