Spontaneous Healing Of Saccular Type Aneurysm With Ventricular Septal Lacerations After Blunt Chest Trauma

Abstract

We present a case of spontaneous healing of saccular type aneurysm with ventricular septal lacerations after blunt chest trauma. A 50-year-old Japanese man was transferred to our hospital diagnosed with ventricular septal lacerations after blunt chest trauma. Electrocardiogram (ECG) at admission showed ST elevations in I, II, III, aVL, aVF, V2-through to V6 were observed. Laboratory data showed elevated creatine kinase. Echocardiogram revealed normal ventricular contraction and a saccular type ventricular septal laceration with an influx blood flow without septal shunt flow. After admission, serial echocardiogram and cardiac computed enhancement tomography showed disappearance of a saccular type ventricular septal laceration. Gadolinium-enhanced magnetic resonance imaging (MRI) was performed at day 30. MRI showed an enhanced scar of saccular type aneurysm with ventricular septal laceration; this image suggested some residual damage of ventricular septal laceration. At discharge, ECG was resolved with normal ST-T level and no Q wave, but persistent complete right bundle branch block and left axis deviation. After one year, repeat MRI showed a scar of saccular type aneurysm with ventricular septal laceration.<Learning objective: To recognize spontaneous healing of saccular type aneurysm with ventricular septal lacerations after blunt chest trauma. This is a case of saccular type aneurysm with ventricular septal laceration after non-penetrating blunt chest trauma successfully healed with conservative therapy. There are many case reports of blunt chest trauma, however, there are few reports of treatment with conservative therapy.