Ventricular septal defect resulting from blunt injury to the chest in a 7-year-old boy.

What is it about?

Ventricular septal defect (VSD) is the most common congenital cardiac lesion seen worldwide. Only very rarely is it acquired, and VSD resulting from blunt chest injury in a child is extremely rare. The case is presented of a previously healthy 7-year-old boy who suffered blunt chest injury while at play. He presented 11 days later in acute heart failure. Two-dimensional echocardiographic examination revealed a mid-muscular VSD. The connection between the defect and the injury was not initially appreciated. Facilities for the required urgent open-heart surgery were not available. The boy did not respond to medical treatment of his heart failure; his clinical condition steadily worsened, and he died 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 heart failure following blunt injury to the chest. Any such patient should undergo careful echocardiographic examination. There is an urgent need for facilities for open-heart surgery to be more readily available and accessible in Nigeria.

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Why is it important?

Traumatic VSD is extremely rare in children. The case is presented for its rarity, to increase awareness of the condition, so as to enable prompt diagnosis to be made in the event that it does occur.

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