title: Delayed diagnosis of traumatic ventricular septal defect in penetrating chest injury: small evidence on echocardiography makes big difference.
abstract: Cardiac trauma from penetrating chest injury is a life-threatening condition. It was reported that < 10% of patients arrives at the emergency department alive. Penetrating chest injury can cause serious damage in more than 1 cardiac structure, including myocardial lacerations, ventricular septal defect (VSD), fistula between aorta and right cardiac chamber and valves. The presence of pericardial effusion (even a small amount) on the initial echocardiography might be the only clue to serious cardiac damage in the absence of definite evidence of anatomical defect in heart. We here present a case, in which clear diagnosis of VSD and pseudoaneurysmal formation was delayed a few days after penetrating chest injury due to the lack of anatomical evidence of damage.
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kihyun
authors.initials: K
authors.lastname: Jeon
authors.forename: Woo-Hyun
authors.initials: WH
authors.lastname: Lim
authors.forename: Si-Hyuck
authors.initials: SH
authors.lastname: Kang
authors.forename: Iksung
authors.initials: I
authors.lastname: Cho
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn