• Terrell Caffery, Danny Robinson, Hollis O'Neal, Azheem Kahn, Scott Thurston, and Mandi Musso.
• Assistant Professor in Louisiana State University Health Sciences Center's School of Medicine and the Program Director of the LSUHSC's Emergency Medicine Residency Program in Baton Rouge.
• J La State Med Soc. 2014 Nov 1; 166 (6): 239-41.

AbstractThis is a case report of a 27-year-old male who sustained a stab wound to the chest with a resulting penetrating cardiac injury and subsequent emergency thoracotomy. The patient survived his injury and on post-op day two, a holosystolic murmur was noted during physical exam, but he remained hemodynamically stable and intubated. A transthoracic echocardiogram revealed the presence of a ventricular septal defect (VSD), with Doppler flow revealing shunting from the left ventricular cavity into the right ventricular cavity. Ultimately, the clinicians decided upon a trial of extubation with a plan for delayed closure of the VSD. Upon extubation,the patient became hypoxemic with evidence of pulmonary edema; thus, he was re-intubated. The defect was surgically repaired, and the patient had an uneventful recovery thereafter. The purpose of this case report is to present an example of delayed detection of a ventricular septal defect after a penetrating cardiac injury.

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