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Incomplete Ventricular Septal Rupture Following Blunt Chest Trauma

A Case Report

Department of Cardiology, Shinshu University School of Medicine, Matsumoto, Japan, kashima{at}qc4.so-net.ne.jp

Osamu Kinoshita, MD, FASA

Department of Cardiology, Shinshu University School of Medicine, Matsumoto, Japan

Uichi Ikeda, MD, FASA

Department of Cardiology, Shinshu University School of Medicine, Matsumoto, Japan

Noriyuki Yajima, MD

Department of Cardiology, Shinshu University School of Medicine, Matsumoto, Japan

Hiroshi Imamura, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Hiroaki Urayama, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Tomomi Iwashita, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Yukio Sekiguchi, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Shingo Akita, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Noriko Wada, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Kazufumi Okamoto, MD

Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan

This report describes a case of traumatic incomplete rupture of the ventricular septum, a rare complication caused by blunt chest trauma. Although a serial ECG progressed its course similar to acute anteroseptal myocardial infarction in this case, there was little clinical clue of septal tear. The diagnosis was established by transthoracic echocardiography. The authors chose a conservative line of management rather than surgical repair for incomplete septal rupture because of the patent’s stable clinical course and hemodynamic status. A sequence of echocardiography during a 32-day stay in the hospital showed no change in the extent of incomplete septal rupture, septal structure, systolic function, and shape of left ventricle and also obtained no evidence of shunting through the rupture. In conclusion, echocardiography is a useful investigation to make a diagnosis as well as for follow-up in case of incomplete ventricular septal rupture. A close follow-up of incomplete septal rupture with serial echocardiography should be performed, because several cases of delayed ventricular septal rupture following blunt chest trauma have been reported.

Angiology, Vol. 57, No. 3, 373-377 (2006)
DOI: 10.1177/000331970605700315


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