Case ReportSudden infant deaths from undiagnosed ventricular septal defect – Report of two autopsy cases
Introduction
Ventricular septal defect (VSD) is one of the most common congenital cardiac diseases. Some authors recently reported higher incidence as 43.6–46.3 [1], [2], although the incidence of VSD have been reported between 2 and 6 per 1000 live births in the past [3], [4]. Researches in Japan have found 6.0–24.4 [5], [6], [7], [8]. Majority of VSD cases has relatively non-aggressive clinical courses; either spontaneous closure or causing congestive heart failure treatable with surgical intervention. Systolic heart murmur usually triggers an awareness of VSD [9]. Some patients, on the other hand, can be diagnosed as VSD earlier using echocardiography or lately after showing symptoms of heart failure. Here we report two autopsy cases of VSD that were not diagnosed antemortem.
Section snippets
Case 1
The patient was an 18-day-old boy. He was born at 40 weeks and 2 days of gestation with a weight of 2904 g, and had no notable previous or family history. He experienced coughing after feeding in his 17th day. He was carried into an emergency unit because he manifested weakness. Heart murmur was not auscultated during physical examination according to the medical record. Any problem was not pointed out except tachypnea and peripheral coldness. His mother breastfed him twice after getting home,
Discussion
Growth and development of both the patients were sufficient. No lethal injuries or major abnormalities except VSD were found. There were no significant results in serum viral antibody titers and cultivation tests of blood and spinal fluid or swab from the respiratory tract, as far as we investigated. No inflammatory lesion was found in any organ in either of the cases. Possibility of fetal infection was thus excluded.
The hearts weighed 42.0 g in case 1 and 36.6 g in case 2, which were heavier
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