Kashima Yuichiro, Kinoshita Osamu, Ikeda Uichi, Yajima Noriyuki, Imamura Hiroshi, Urayama Hiroaki, Iwashita Tomomi, Sekiguchi Yukio, Akita Shingo, Wada Noriko, Okamoto Kazufumi
Department of Cardiology, Shinshu University School of Medicine, Matsumoto, Japan.
Angiology. 2006 May-Jun;57(3):373-7. doi: 10.1177/000331970605700315.
This report describes a case of traumatic incomplete rupture of the ventricular septum, a rare complication caused by blunt chest trauma. Although a serial ECG progressed its course similar to acute anteroseptal myocardial infarction in this case, there was little clinical clue of septal tear. The diagnosis was established by transthoracic echocardiography. The authors chose a conservative line of management rather than surgical repair for incomplete septal rupture because of the patent's stable clinical course and hemodynamic status. A sequence of echocardiography during a 32-day stay in the hospital showed no change in the extent of incomplete septal rupture, septal structure, systolic function, and shape of left ventricle and also obtained no evidence of shunting through the rupture. In conclusion, echocardiography is a useful investigation to make a diagnosis as well as for follow-up in case of incomplete ventricular septal rupture. A close follow-up of incomplete septal rupture with serial echocardiography should be performed, because several cases of delayed ventricular septal rupture following blunt chest trauma have been reported.
本报告描述了一例室间隔创伤性不完全破裂病例，这是一种由钝性胸部创伤引起的罕见并发症。尽管在此病例中，系列心电图的变化过程类似于急性前间隔心肌梗死，但几乎没有室间隔撕裂的临床线索。诊断是通过经胸超声心动图确定的。由于患者临床过程稳定且血流动力学状态良好，作者对于不完全性室间隔破裂选择了保守治疗方案而非手术修复。在住院32天期间进行的一系列超声心动图检查显示，不完全性室间隔破裂的程度、间隔结构、收缩功能以及左心室形状均无变化，也未发现有通过破裂处的分流证据。总之，超声心动图对于诊断以及不完全性室间隔破裂病例的随访是一种有用的检查方法。对于不完全性室间隔破裂应通过系列超声心动图进行密切随访，因为已有报道称钝性胸部创伤后出现延迟性室间隔破裂的病例。
