Ventricular septal perforation after blunt chest trauma due to blows from a fist

摘要

CaseA 40‐year‐old man received fist blows to his chest and abdomen. He presented with external jugular vein distention and facial congestion. Chest X‐ray showed bilateral pulmonary congestion. A Levine V/VI holosystolic murmur was audible. Echocardiography showed left‐to‐right shunt flow across the perimembranous region of the ventricular septum. The diameter of the hole was approximately 13 mm. We diagnosed ventricular septal perforation, started an infusion, and administered vasopressors. However, circulatory dynamics could not be maintained. The ventricular septal perforation was repaired directly with mattress sutures through the right ventricle. A small residual ventricular septal perforation was detected, which was repaired with a patch sutured through the left ventricle.