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A large ventricular septal defect complicating resuscitation after blunt trauma.
MedLine Citation:
PMID:  23248508     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Henry D I De'Ath; Paul E D Vulliamy; Ceri Davies; Rakesh Uppal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of emergencies, trauma, and shock     Volume:  5     ISSN:  0974-2700     ISO Abbreviation:  J Emerg Trauma Shock     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-12-18     Completed Date:  2012-12-19     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101493921     Medline TA:  J Emerg Trauma Shock     Country:  India    
Other Details:
Languages:  eng     Pagination:  350-2     Citation Subset:  -    
Affiliation:
Trauma Clinical and Academic Unit, The Royal London Hospital, Whitechapel, London, E1 1BB,, United Kingdom.
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