Multiple intracardiac lesions after blunt chest trauma

Multiple ventricular septal rupture after blunt trauma

Ventricular septal rupture occurring as a result of blunt trauma is a very rare clinical condition. Compression of the heart between the sternum and the vertebral column during late diastole or isovolumetric contraction resulting in sudden increase in the intracardiac pressure is a prerequisite for its occurrence. Sudden relief of the inner pressure becomes impossible when the heart is full, thereby resulting in myocardial contusion and rupture. We report a case of a young schoolboy who presented to us with this serious disease and was successfully treated with surgical closure of the defect with a polytetrafluoroethylene patch.

Simultaneous aortic and tricuspid valve rupture after fall injury

This case study concerns a patient with disruption of both tricuspid and aortic valves: a previously healthy, adult man, who sustained a 5-meter fall from a building under construction. The mechanism of the injury was acceleration and deceleration, acting in two different phases of the cardiac cycle, i.e. systole and diastole. Simultaneous occurrence of these injuries is exceedingly rare and in a careful literature review, we did not find any such combination of injury. The possible mechanisms of this injury, as well as surgical techniques are discussed.

Nonpenetrating right atrial and pericardial trauma

Nonpenetrating chest trauma can cause cardiac rupture. Ventricles are affected more frequently than atria. Survival is rare and depends upon prompt diagnosis and immediate surgical intervention. We report the case of a 42-year-old man involved in a car accident with consequent right atrial rupture and pericardial tearing.

Trauma to cardiac valves

Cardiorrhaphy is a relatively common procedure performed in a trauma center. However, there is a subgroup of patients with more complicated cardiac injuries such as coronary artery injuries, septal defects, and valvular injuries. Cardiac valvular injuries are often diagnosed subacutely when a new murmur is heard. Transesophageal echocardiography has been increasingly performed to diagnosis these injuries and may be helpful intraoperatively. Cardiac catheterization may be indicated in selected patients. Techniques to address these injuries may involve repair or prosthetic replacement. A high index of suspicion is needed to diagnose these relatively rare injuries.