Ruptured interventricular septum after blunt chest trauma: ultrasonographic diagnosis.
A 6-year-old child was found under a heavy bookcase that compressed her chest. On admission to the emergency room she was found to be dyspneic with a systolic murmur and complete atrioventricular (A-V) block. Her condition deteriorated rapidly, leading to cardiogenic shock and loss of consciousness. Echocardiographic Doppler evaluation demonstrated a large ventricular septal defect and tricuspid insufficiency. A pericardial patch was put over the tear in the septum, and torn chordae tendinae were reimplanted to the papillary muscles. A pacemaker was inserted. Her situation improved, but on the third day cardiogenic shock and right ventricular dysfunction ensued and the patient expired. A review of the previous 13 cases from the pediatric literature is presented.
Harel
Y
Y
Pediatric Critical Care Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Szeinberg
A
A
Scott
W A
WA
Frand
M
M
Vered
Z
Z
Smolinski
A
A
Barzilay
Z
Z
D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology*; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging