CTICasesAcquired Ventricular Septal Defect and Intracardiac Bullet Fragment
Imaging findings
Chest CT in a patient with a history of a penetrating gunshot wound to the abdomen and chest demonstrates a retained bullet fragment within the right ventricle. Additionally, a small, muscular ventricular septal defect is noted between the left and right ventricles, resulting from the trajectory of the bullet.
Key takeaways
Penetrating trauma to the heart (such as from gunshot or stab wounds) can result in acquired ventricular septal defects and intracardiac foreign bodies. Small, hemodynamically stable muscular VSDs may be managed conservatively initially, allowing the surrounding myocardium to heal and fibrous tissue to contract before deciding on surgical or percutaneous closure.
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