A Case of Slowly Progressing Aneurysm of Left Ventricle and Thoracic Aorta Due to Automobile Blunt Trauma

ABSTRACT

A five-year-old boy received a blunt trauma on chest by a kindergarten bus on Feb. 29, 1996. Pulmonary hemorrhage and pericardiac effusion were developed, followed by multi-organ failure threatening his life. All symptoms were improving when pansystolic harsh murmur (III/IV) originating from a tiny ventricular rupture with a blood leak to the pericardial space was auscultated on the 12th day after the trauma. This murmur disappeared with the left ventricular healing and progressive aneurysmatic formation. Howeve, on the 61st day after the trauma a continuous murmur (II/III) of aortic dissecting aneurysm on the left upper sternal border and dorsum was newly auscultated. Two-dimensional color doppler echocardiogram and aortogram by femoral artery catheterization revealed aneurysmatic dilatations of both the left ventricular free wall and descending aorta immediately after the origin of the subclavian artery with mild mitral regugitation. The patient underwent successful corrective surgery.