RAPTURED INTERVENTRICULAR SEPTUM AFTER BLUNT CHEST TRAUMA - ULTRASONOGRAPHIC DIAGNOSIS

A 6-year-old child was found under a heavy bookcase that compressed he r chest, On admission to the emergency room she was found to be dyspne ic with a systolic murmur and complete atrioventricular (A-V) block. H er condition deteriorated rapidly, leading to cardiogenic shock and lo ss of consciousness. Echocardiographic Doppler evaluation demonstrated a large ventricular septal defect and tricuspid insufficiency. A peri cardial patch was put over the tear in the septum, and torn chordae te ndinae were reimplanted to the papillary muscles, A pacemaker was inse rted. Her situation improved, but on the third day cardiogenic shock a nd right ventricular dysfunction ensued and the patient expired. A rev iew of the previous 13 cases from the pediatric literature is presente d.