Traumatic Ventricular Septal Defect Caused by a Horse Kick Injury: 2 Rare Pediatric Cases.
Abstract: We present 2 cases of traumatic ventricular septal defects (VSDs), both caused by horse kick injuries. Given this rare but critical condition, we decided to share our experiences and the lessons learned managing these cases. Methods: The first patient, a 12-year-old girl, was trampled by a horse, sustained a traumatic apical ventricular septal defect with pseudoaneurysm, was stabilized first, and underwent surgical closure 19 days after the injury. The second patient, a 9-year-old girl, was kicked by a horse in the chest; developed profound cardiogenic shock; and was found to have multiple large muscular VSDs, biventricular dysfunction, and pulmonary edema requiring emergent repair. Conclusions: Presentation of traumatic VSDs can vary, ranging from a stable patient to a patient presenting in cardiogenic shock. Immediate closure is not without risks but may be the only option in some cases. Conclusions: Outcomes of traumatic VSDs are excellent, although emergent VSD closure might be necessary.
Crown Copyright © 2025. Published by Elsevier Inc. All rights reserved.
Publication Date: 2025-08-02 PubMed ID: 40750180DOI: 10.1016/j.jaccas.2025.104350Google Scholar: Lookup
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Summary
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This research article discusses two unique cases where young girls developed traumatic ventricular septal defects (VSDs) as a result of horse kick injuries and the varied responses required to address these medical emergencies.
Objective and Overview
The researchers outline two pediatric cases of traumatic VSDs, a heart condition brought on by severe injuries from horse kicks. The intent is to share their experiences for the benefit of other medical professionals who may encounter such rare circumstances.
Case Studies
Two subjects, a 12-year-old and a 9-year-old girl, were studied.
- The first case involved a 12-year-old girl who sustained an apical ventricular septal defect, a hole at the lower part of the septum, along with a pseudoaneurysm (false aneurysm) as she was trampled by a horse. The girl was first stabilized and underwent surgical closure 19 days after the incident.
- The second case was of a 9-year-old girl who was kicked in the chest by a horse. The impact caused multiple muscular VSDs, biventricular dysfunction, where both ventricles of the heart are unable to pump enough blood, and pulmonary edema, a condition that causes excess fluid in the lungs. These conditions were so severe that they induced profound cardiogenic shock, requiring immediate repair.
Conclusions
From these cases, the scientists concluded that the manifestation of traumatic VSDs can be multifaceted, with patients varying from being stable to experiencing cardiogenic shock.
- While instant closure of these defects isn’t without potential complications, in extreme cases such as the one with the 9-year-old girl, it might be the only viable option.
- Despite VSDs being a serious health emergency, their outcomes can be excellent if addressed appropriately, as shown by the successful recoveries of the patients discussed here.
Through their experiences managing these unusual cases, the researchers hope to offer insight into potential treatment approaches for critical traumatic VSDs, particularly in a pediatric setting.
Cite This Article
APA
Weixler VHM, Aldana-Aguirre J, Zaulan O, Chin V, Guerguerian AM, Mertens L, Honjo O.
(2025).
Traumatic Ventricular Septal Defect Caused by a Horse Kick Injury: 2 Rare Pediatric Cases.
JACC Case Rep, 30(21), 104350.
https://doi.org/10.1016/j.jaccas.2025.104350 Publication
Researcher Affiliations
- Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada. Electronic address: weixlervhm@gmail.com.
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Cardiac Critical Care, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Anesthesia & Pain Medicine, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Cardiac Critical Care, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.
Conflict of Interest Statement
Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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