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Traumatic intracardiac communication: detection by color flow mapping.
C A Clyne1, G Aurigemma, A Sweeney
1Department of Medicine, University of Massachusetts, Worcester 01655.
Summary
A traumatic ventricular septal defect developed in a young man after surgery for a knife wound. Echocardiography revealed a left-to-right shunt, indicating abnormal blood flow between heart ventricles.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
- Diagnostic Imaging
Background:
- A previously healthy 20-year-old man sustained a right ventricular free wall laceration from a knife wound.
- Emergency surgery was performed for repair of the laceration.
Observation:
- A new systolic murmur was detected one month post-surgery.
- Two-dimensional echocardiography and color flow mapping identified a communication between the left and right ventricles.
- Turbulent flow was observed in the region of the membranous septum, consistent with a ventricular septal defect.
Findings:
- The defect appeared to extend posteriorly into the left atrium.
- Cardiac catheterization quantified a left-to-right shunt ratio of 1.2:1.
Implications:
- This case highlights a rare complication of penetrating cardiac trauma.
- Delayed diagnosis of traumatic ventricular septal defects is possible.
- Advanced imaging and hemodynamic assessment are crucial for accurate diagnosis and management.