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Chest trauma and subvalvular left ventricular aneurysms.

R V Matthews¹, W J French, J M Criley

¹Department of Medicine, UCLA School of Medicine.

|February 1, 1989

Summary

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Blunt chest trauma can cause pulsatile saccular lesions, specifically left ventricular aneurysms, leading to mitral regurgitation. These rare acquired lesions require prompt diagnosis via imaging in trauma patients with heart valve issues.

Area of Science:

Cardiovascular Medicine
Trauma Surgery
Diagnostic Imaging

Background:

Annular subvalvular aneurysms are typically congenital defects or acquired after endocarditis/valve replacement.
Mitral regurgitation can arise from various cardiac pathologies, including trauma.

Observation:

Two patients presented with pulsatile saccular lesions at the left ventricle base post-blunt chest trauma.
Lesions were associated with mitral regurgitation.
One patient had multiple aneurysms; the other had an aneurysm continuous with a ventricular septal defect.

Findings:

Echocardiography and magnetic resonance imaging confirmed the presence of these left ventricular aneurysms.
The aneurysms mimicked previously described annular subvalvular aneurysms.

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Implications:

Chest trauma can lead to acquired left ventricular aneurysms and mitral regurgitation.
These aneurysms should be actively sought in patients presenting with valvar regurgitation after chest trauma.
Advanced imaging modalities are crucial for diagnosis.