DUDU DUYGU CİVAN, ALPER KOKER, ERDEM ÇEBİŞLİ, NAZAN ÜLGEN TEKEREK, ZEYNEP ÇAĞLA MUTLU, MUHAMMET BULUT, FİLİZ EKİCİ, OGUZ DURSUN
Pediatric Academic Case Reports - 2025;4(3):63-66
It has been reported that ventricular septal aneurysm and ventricular septal defect (VSD) may rarely develop after blunt thoracic trauma. This case report presents a pediatric case that developed VSD in the follow-up after an in-vehicle traffic accident. A 15-month-old patient had an in-vehicle traffic accident; since no additional problem was detected, he was discharged after a short follow-up. The patient was admitted to the hospital with respiratory distress five days after the trauma, with the symptoms of tachypnea and a 2/6 systolic murmur in the pulmonary focus. In echocardiography, the interventricular septum was intact, sASD and pulmonary hypertension secondary to lung contusion were present. He was transferred to the pediatric intensive care unit and intubated on the sixth day; adrenaline and milrinone were started due to hypotension. On the seventh day, echocardiography revealed a 7 mm VSD with a left-to-right shunt in the apical muscular region, and interventricular septal hypertrophy was detected. In angiography, the right ventricle was filled with two muscular defects of 4.2 mm in the apical region on the interventricular septum and the area near the middle. Direct and indirect mechanisms are well defined in the literature, and our patient’s VSD occurred due to a delayed inflammatory response due to liquefaction necrosis following myocardial damage. Similar to the literature, apical muscular VSD was detected in your patient. The patient is followed closely without surgical intervention in the 11th month of follow-up. It should be kept in mind that secondary VSD may develop within days after blunt chest trauma.
