title: Ventricular septal necrosis after blunt chest trauma.
abstract: Ventricular Septal Defect (VSD) after blunt chest trauma is a very rare traumatic affection. We report here a case of blunt chest injury-related VSD and pseudoaneurysm.    A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edema and echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely the intracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue some hidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinical sequelae.
authors.affiliation: Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Feridoun
authors.initials: F
authors.lastname: Sabzi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Niazi
authors.forename: Abdol Hamid
authors.initials: AH
authors.lastname: Zokaei
authors.forename: Farzad
authors.initials: F
authors.lastname: Sahebjamee
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan Hejazi
authors.forename: Alireza
authors.initials: A
authors.lastname: Ahmadi
mesh_terms: D000328:Adult; D004452:Echocardiography; D006801:Humans; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology; D012253:Rib Fractures / Q000150:complications; D012421:Rupture / Q000209:etiology / Q000601:surgery; D013898:Thoracic Injuries / Q000150:complications*; D054088:Ventricular Septum / Q000293:injuries* / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000150:complications*
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