Delayed ventricular septal rupture complicating acute inferior wall myocardial infarction

Jae Hyung Cho, Srinivasan Sattiraju, Sanjay Mehta, Emil Missov

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Ventricular septal rupture is a potentially fatal complication of acute myocardial infarction. Its incidence has declined with modern reperfusion therapy. In the era of percutaneous coronary interventions, it occurs a median of 18-24 hours after myocardial infarction and is most commonly associated with anterior myocardial infarction. We present a case of delayed ventricular septal rupture complicating acute inferior wall myocardial infarction. Case presentation. A 53-year-old Caucasian male presented with epigastric pain for three days and electrocardiographic evidence for an acute inferior wall myocardial infarction. Coronary angiography revealed a total occlusion of the proximal right coronary artery. Reperfusion was achieved by balloon angioplasty followed by placement of a bare metal stent. On hospital day six, the patient developed acute respiratory distress, a new loud pansystolic murmur, and hemodynamic instability. Echocardiography revealed the presence of a large defect in the inferobasal interventricular septum with significant left-to-right shunt consistent with ventricular septal rupture. The patient underwent emergent surgical repair with a bovine pericardial patch. Conclusion: Ventricular septal rupture after myocardial infarction should be suspected in the presence of new physical findings and hemodynamic compromise regardless of revascularization therapy.

Original languageEnglish (US)
Article number124
JournalBMC Research Notes
Volume6
Issue number1
DOIs
StatePublished - Mar 29 2013

Keywords

  • Echocardiography
  • Myocardial infarction
  • Surgery
  • Ventricular septal rupture

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