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Interventricular Septal Pseudoaneurysm After Blunt Chest Trauma in a 6 Year Old: An Illustrative Case and Review

Natalie Behrle1, Peter Dyke, Abdallah Dalabih

  • 1From the Department of Child Health, University of Missouri, Columbia, MO.

Pediatric Emergency Care
|September 27, 2016
PubMed

Insights

Motor vehicle accidents commonly cause blunt cardiac injury in children. A rare case of interventricular septal pseudoaneurysm after trauma highlights the need for cardiac monitoring and evaluation in pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Trauma Surgery
  • Cardiovascular Imaging

Background:

  • Motor vehicle accidents are the leading cause of blunt cardiac injury (BCI) in children, accounting for 85.3% of cases.
  • Chest trauma can result in myocardial contusion, ventricular septal defects (VSD), or valve compromise.
  • Proposed mechanisms for VSD formation include ischemic myocardial rupture or reopening of congenital VSDs.

Observation:

  • A 6-year-old girl developed an interventricular septal pseudoaneurysm following a pedestrian vs. car accident.
  • Bradycardia and the need for cardiopulmonary resuscitation post-abdominal surgery prompted an emergent echocardiogram.
  • The echocardiogram revealed an interventricular pseudoaneurysm, which has been managed conservatively with serial monitoring.

Findings:

  • Blunt cardiac injury in children can lead to rare but serious cardiac complications like pseudoaneurysms.
  • Interventricular pseudoaneurysms, though rare, may not always require immediate surgical intervention.
  • Conservative management with serial echocardiographic follow-up can be a viable option for certain BCI-related cardiac injuries.

Implications:

  • This case underscores the importance of considering cardiac injury in pediatric trauma patients, even after initial stabilization.
  • Prompt echocardiographic evaluation is crucial for diagnosing structural heart disease following blunt chest trauma.
  • Understanding the risk factors and diagnostic modalities for BCI is essential for optimizing patient outcomes.

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