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Case of ventricular septal rupture following acute myocardial infarction.

ABSTRACT: Ventricular septal rupture is a rare and potentially fatal complication of transmural myocardial infarction. Early identification utilising transthoracic echocardiography significantly improves long term outcomes in these patients. We report on a case of a 77-year-old male who presented with signs and symptoms of cardiac failure and a loud systolic murmur. The patient underwent an initial point-of-care ultrasound which revealed evidence of a transmural myocardial infarction and a high suspicion of an apical ventricular septal rupture. A complete transthoracic echocardiogram confirmed the septal rupture diagnosis and the patient subsequently underwent surgical repair of the ventricular rupture. This case highlights the role of echocardiography in decreasing adverse outcomes in patients with ventricular septal rupture.

SUBMITTER: Amorosi NM

PROVIDER: S-EPMC7412945 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Multimodality cardiac imaging of a ventricular septal rupture post myocardial infarction: a case report.

Project description:BackgroundVentricular septal rupture (VSR), a mechanical complication following an acute myocardial infarction (MI), is thought to result from coagulation necrosis due to lack of collateral reperfusion. Although the gold standard test to confirm left-to-right shunting between ventricular cavities remains invasive ventriculography, two-dimensional transthoracic echocardiography (TTE) with color flow Doppler and cardiac MRI (CMR) are reliable tests for the non-invasive diagnosis of VSR.Case presentationA 62-year-old Caucasian female presented with a late case of a VSR post inferior MI diagnosed by multimodality cardiac imaging including TTE, CMR and ventriculography.ConclusionWe review the presentation, diagnosis and management of VSR post MI.

| S-EPMC3505164 | biostudies-literature

Post-myocardial infarction ventricular septal rupture in a patient with large secundum atrial septal defect: a case report.

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| S-EPMC6601236 | biostudies-literature

Double ventricular rupture after acute myocardial infarction: A rare case report.

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Two-patch technique with BioGlue for ventricular septal rupture resulting from acute anterior myocardial infarction

Project description: Not available

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Concurrent true inferoposterior left ventricular aneurysm and ventricular septal rupture secondary to inferior myocardial infarction: a case report.

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Delayed ventricular septal rupture complicated with ventricular aneurysm in a case of myocardial infarction with non-obstructive coronary arteries.

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Lethal complication: Ventricular septal perforation and right ventricular infarction after acute myocardial infarction.

Project description:Here, we report a case of ventricular septal perforation complicated with right ventricular infarction after inferior acute myocardial infarction, which was associated with a poor clinical outcome despite the successful surgical treatment.

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A Case Report: Point-of-care Ultrasound in the Diagnosis of Post-Myocardial Infarction Ventricular Septal Rupture.

Project description:IntroductionVentricular septal rupture (VSR) is a rare complication of ST-elevation myocardial infarction (STEMI), typically discovered post-revascularization.Case reportWe present the first case of VSR detected on point-of-care ultrasound (POCUS) in the emergency department immediately prior to emergent angiography, with management positively affected by this discovery. The VSR was quickly confirmed via right heart catheterization. Subsequently, hemodynamic stability was achieved using an intra-aortic balloon pump. A delayed surgical VSR repair, with concomitant coronary artery bypass grafting, was implemented for definitive management.ConclusionThis case highlights the utility of POCUS in a STEMI patient with a suspected mechanical complication.

| S-EPMC7434273 | biostudies-literature

Clinical Characteristics and Contemporary Prognosis of Ventricular Septal Rupture Complicating Acute Myocardial Infarction: A Single-Center Experience.

Project description:Objectives: Ventricular septal rupture (VSR) is a rare but lethal complication of acute myocardial infarction (AMI). We conducted a retrospective analysis of the clinical characteristics of VSR patients and explored the risk factors for long-term mortality. Methods: In this single-center cohort study, 127 patients diagnosed with post-AMI VSR between May 2012 and April 2019 were included. Demographic, clinical, operative, and outcome data were collected. The 30-day and long-term mortality were outcomes of interest. Cox proportional hazard regression analysis was used to explore the predictors of long-term mortality. Results: The mean age of the VSR cohort was 66.6 ± 8.7 years, 67 (52.8%) were males. Among the 127 patients, 78 patients (61.4%) were medically managed, 31 (24.4%) patients underwent percutaneous transcatheter closure (TCC), and 18 (14.2%) patients received surgical repair. The median follow-up time was 1129 days [interquartile range: 802-2019 days]. The 30-day mortality of the medically managed group, percutaneous TCC group, and surgical management group was 93.6, 22.6, and 11.1%, respectively; and the long-term mortality was 96.2, 25.8, and 22.2%, respectively. VSR repair treatment including surgical management (HR 0.01, 95% CI 0.001-0.09, p < 0.001) and percutaneous TCC (HR 0.09, 95% CI 0.03-0.26, p < 0.001) was associated with a better prognosis, and cardiogenic shock (CS) (HR 9.30, 95% CI 3.38-25.62, p < 0.001) was an independent risk factor of long-term mortality. Conclusions: The prognosis of VSR patients without operative management remains poor, especially in those complicated with CS. Timely and improved surgery treatment is needed for better outcomes in VSR patients.

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Normal coronary myocardial infarct is innocent or guilty? A case of ventricular septal rupture secondary to normal coronary myocardial infarction.

Project description:Prognosis of cases of myocardial infarction with normal coronary arteries (MINCA) is known to be better than acute myocardial infarction cases with obstructive coronary lesions. A MINCA case causing ventricular septal rupture is rare. Herein, we present a 70-year-old female MINCA case which caused ventricular septal rupture which is a fatal complication of acute myocardial infarction. <Learning objective: Acute myocardial infarction, whether it is atherosclerotic or non atherosclerotic, has a high mortality rate when complicated with ventricular septal rupture. Complications of acute myocardial infarction should be observed cautiously and specific risk factors for ventricular septal rupture need to be investigated.>.

| S-EPMC6277914 | biostudies-literature

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