Acquired ventricular septal defect: A rare sequel of blunt chest trauma in a 7‑year‑old boy

Abstract

Ventricular septal defect (VSD) is the most common congenital cardiac lesion encountered worldwide. Only very rarely is it acquired, and causation through blunt injury in a child is extremely rare. A previously healthy 7‑year‑old boy suffered blunt chest trauma while at play. He presented 11 days later with features of acute congestive cardiac failure. Two‑dimensional echocardiographic examination revealed a mid‑muscular VSD. The connection between the defect and the trauma was not initially appreciated. Facilities for required urgent open‑heart surgery were not available. Cardiac failure was refractory to antifailure therapy. His clinical condition steadily worsened, and he succumbed after 20 days on admission. We conclude that a diagnosis of traumatic VSD, though rare, should be considered in any previously well child presenting in acute congestive cardiac failure following blunt trauma to the chest. Any such patient should undergo careful echocardiographic evaluation. There is an urgent need for facilities for open‑heart surgery to be more readily available and accessible in Nigeria.

Key words: Acquired ventricular septal defect, traumatic ventricular septal defect, blunt chest injury, cardiac failure, echocardiography