Late Presentation of Complex Cardiac Defect Following Penetrating Cardiac Trauma: Case Report

Six months ago, a 23-year-old man who involved in an altercation and received a stab wound (SW) to the chest, medial to the left nipple, he was admitted to our clinic with 2-month history of shortness of breath. Transthoracic echocardiography and Doppler color flow imaging showed a large amount of pericardial effusion, aorto-left atrial fistula and a defect in the upper part of the interventricular septum resulting in a left to right ventricular shunt. Successful surgical treatment including pericardial drainage and closure of the defects with Dacron graft was performed. Postoperatively, a complete atrioventricular block was developed, because of its persistance permanent pacemaker was implanted. This present case illustrates delayed presentation of complex cardiac SW that did not cause acute symptoms, optimal diagnosis and surgical management of the defects.