Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case
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CASE REPORT
Open Access
Traumatic ventricular septal rupture associated with rapid progression of heart failure despite low Qp/Qs ratio: a case report Kosuke Murakawa1*, Susumu Yoshida1, Takayuki Okada2, Chie Toyoshima1, Reisuke Yuyama3, Naoki Minato2 and Ichiro Shiojima1
Abstract Background: Ventricular septal rupture (VSR) secondary to blunt chest trauma is rare and associated with a diverse range of symptoms and clinical courses as well as disease severity. We present a case of traumatic VSR in which rapid progression of heart failure was observed in spite of relatively low pulmonary to systemic blood flow (Qp/Qs) ratio. Case presentation: A 40-year-old male was transported to the emergency department approximately 12 h after blunt chest trauma. VSR was diagnosed by echocardiography, and right heart catheterization revealed a Qp/Qs ratio of 1.52. Although medical treatment was initially attempted, subsequent rapid progression of heart failure necessitated emergent surgical repair of VSR. Conclusions: Because small, asymptomatic VSR often close spontaneously, surgical repair of traumatic VSR is indicated when the shunt rate is relatively large or heart failure is present. However, the present case highlights the need to consider emergent surgical repair of traumatic VSR, even when the shunt rate is relatively small. Keywords: Ventricular septal rupture, Blunt chest trauma, Low shunt rate, Emergency surgical closure, Early mechanical rupture
Background Secondary ventricular septal rupture (VSR) is a wellknown complication of myocardial infarction. In the current myocardial reperfusion era, incidence rates of VSR complicating myocardial infarction are
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