A penetrating wound to the heart can result in a traumatic ventricular septal defect (VSD).


Clinical features:

(1) History of stab or other penetrating wound to the chest.

(2) Most (but not all patients) have hemopericardium with tamponade and/or hemothorax requiring immediate surgery.

(3) Left-to-right intracardiac shunt with holosystolic murmur.

(4) Exertional dyspnea associated with the shunt.

(5) Variable bundle branch block or other conduction defect.

(6) Variable damage to valves or other intracardiac structures.


The presence of a VSD may not be recognized immediately, especially if there are multiple life-threatening injuries.


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