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Gunshot wounds: causing myocardial infarction, delayed ventricular septal defect, and congestive heart failure

Sudeep Kumar1, Nagaraja Moorthy, Aditya Kapoor

  • 1Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. sudeep@sgpgi.ac.in

Texas Heart Institute Journal
|March 14, 2012
PubMed

Insights

Delayed cardiac complications, such as ventricular septal defects, can arise months after chest trauma. Early recognition is crucial for managing these severe injuries.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Cardiovascular Surgery

Background:

  • Penetrating chest trauma can lead to diverse cardiac injuries.
  • Myocardial contusion, septal damage, and coronary artery lacerations are common.
  • Delayed complications, like ventricular septal defects, can occur.

Observation:

  • A 21-year-old man presented with heart failure due to an old myocardial infarction.
  • This was complicated by a delayed ventricular septal defect (VSD) formation.
  • The VSD and myocardial infarction were sequelae of gunshot wounds sustained 6 months prior.

Findings:

  • Left ventricular angiography revealed an apical aneurysm and a large, muscular VSD.
  • 19 gunshot pellets were identified within the chest wall.
  • Surgical intervention included aneurysmectomy and VSD closure.

Implications:

  • This case highlights that significant cardiac injuries may manifest months post-trauma.
  • Traumatic VSD should be suspected in trauma patients with new heart murmurs, even without apparent chest injury.
  • Prompt surgical management led to full recovery and asymptomatic status.

Keywords:
Coronary aneurysm/etiologyheart injuries/complications/diagnosis/physiopathology/surgerymyocardial infarction/etiologytreatment outcomeventricular septal rupture/etiologywounds, penetrating/physiopathology

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