Isolated ventricular septal defect caused by nonpenetrating trauma to the chest.

From the Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland. Dr. Mason is now in El Macero, California. Dr. Roberts is now with the Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas. Corresponding author: Dean T. Mason, MD, 44725 Country Club Drive, El Macero, California 95618. Nonpenetrating trauma to the chest often results in injury to the heart, which may vary in severity from immediately fatal cardiac rupture to asymptomatic cardiac bruises. Contusion of the myocardium, as evidenced by electrocardiographic abnormalities, has been the most common lesion found clinically, and rupture of the myocardium has been the most common injury found at autopsy following nonpenetrating chest trauma. The rupture usually involves the free wall of either or both ventricles and rapidly leads to death. On occasion, the ventricular septum is ruptured without perforation of a ventricular free wall. This report describes a patient who survived isolated rupture of the ventricular septum following blunt trauma to the chest and summarizes pertinent features of some cases that have been reported. • • • A 24-year-old laborer was in excellent health until October 1960, when he was involved in an automobile accident. He struck his chest against the steering wheel after hitting the rear of a truck and was knocked unconscious. Upon awakening approximately 1 hour later, he heard and felt a “purring” sensation over his precordium and was hospitalized. The patient had had no previous history of cardiac disease, and no precordial murmur