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[18 years after a penetrating heart injury: follow-up]
Insights
A penetrating chest trauma case in an 11-year-old boy resulted in pericardial tamponade and ventricular septum defect. Echocardiography proved vital in assessing cardiac function 18 years post-surgery.
Area of Science:
- Cardiology
- Trauma Surgery
- Diagnostic Imaging
Background:
- Penetrating chest trauma can cause life-threatening cardiac injuries.
- Surgical repair of cardiac defects is critical for patient survival.
- Long-term non-invasive monitoring is essential for assessing cardiac function after trauma.
Observation:
- An 11-year-old boy sustained penetrating chest trauma leading to pericardial tamponade and ventricular septum defect.
- Initial surgery in 1968 corrected tamponade but not the intracardiac shunt.
- A calcified hematoma was removed 10 years post-surgery, but the shunt persisted.
Findings:
- Multiple non-invasive methods assessed cardiac function 18 years post-trauma.
- Echocardiography, including contrast, Doppler, and color-coded Doppler, was crucial for diagnosis.
- Diagnostic value of echocardiography in complex cardiac trauma cases is highlighted.
Implications:
- This case underscores the importance of comprehensive cardiac assessment after trauma.
- Advanced echocardiographic techniques offer significant diagnostic capabilities for intracardiac shunts.
- Long-term follow-up is crucial for managing residual cardiac defects post-trauma and surgery.
Abstract:
This report presents a case of penetrating chest trauma leading to pericardial tamponade and ventricular septum defect successfully resuscitated by surgery in 1968 in an 11-year-old boy. 10 years later a first-size calcified hematoma was removed. However the 30% left to right intracardiac shunt flow as established by complete heart catheterization prior to surgery was not corrected. Non-invasive methods were used to assess cardiac function 18 years after the initial event including physical examination, chest X-ray, thoracic computer tomography, ECG, 24 h Holter monitoring and exercise testing, combined with myocardial scintigraphy and radionuclide angiography and echocardiographic techniques using the transthoracic and the transoesophageal approach. The diagnostic value of echocardiographic examinations is emphasized with special reference to contrast- and Doppler-echocardiography including the color-coded Doppler-flow-imaging technique.