scholarly journals The Role of Echocardiography in the Assessment of Ventricular Septal Rupture Postmyocardial Infarction

2017 ◽  
Vol 33 (4) ◽  
pp. 291-294 ◽  
Author(s):  
Michael Rampoldi ◽  
Eric Kallstrom
Keyword(s):  
Myocardial Infarction ◽  
Surgical Intervention ◽  
Rapid Assessment ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Anterior Myocardial Infarction ◽  
Postmyocardial Infarction ◽  
Life Threatening

Ventricular septal rupture (VSR) is a rare life-threatening mechanical complication secondary to acute myocardial infarction that usually occurs 2 to 8 days after infarction and frequently precipitates cardiogenic shock. The mortality rate for VSR has been reported to be between 41% and 80%; therefore, immediate surgical intervention should be considered. Furthermore, VSR is a complication of 0.17% to 0.31% of patients who present with an anterior myocardial infarction. Because of the rarity of this pathology, the role of transthoracic echocardiographic investigation will help to improve what is already considered a poor prognosis for these types of patients. This case study illustrates how transthoracic echocardiography plays an essential role in the rapid assessment and diagnosis of VSR in clinical practice.

scholarly journals Ventricular Septal Rupture following Anterior Acute Myocardial Infarction: A Challenge to a Sub-District Physician

2021 ◽  
Vol 7 (1) ◽  
pp. 48-53
Author(s):  
Aditya Doni Pradana ◽  
Jarot Widodo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Rare Complication ◽  
Hemodynamic Instability ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Anterior Myocardial Infarction ◽  
Mortality And Morbidity ◽  
Mechanical Complications ◽  
Resource Setting

Background: Ventricular septal rupture (VSR) is one of the most serious mechanical complications following acute myocardial infarction (AMI). Although a rare complication, it is associated with significant mortality and morbidity. The purpose of this report was to present a case of VSR following anterior AMI in our hospital. Case Description: A 54-year old Javanese male presented persistent episode of breathlessness and lower limb swelling for the last two days with prior chest pain 7 days ago. Physical examination revealed a grade 3/6 holosystolic murmer loudest over the apex, S3 gallop, rales bibasally of the lung. Electrocardiographic evidence revealed for a recent anterior myocardial infarction. Chest X-Ray showed a cardiomegaly and pulmonary congestion. Transthoracic echocardiography revealed VSR at mid-anteroseptal with estimated length of 8-10 mm, preserved LVEF 51% with mid-apicoseptal akinesis. Multiple readmissions were noted for this patient in the follow-up with worsened conditions. Discussion: This is a challenging case report since our hospital is an incapable cath-lab sub-district hospital and far from PCI-capable center. It is critical that all patients with AMI have a brief evaluation for mechanical complications such as VSR. All patients who developed hemodynamic instability during AMI should be comprehensively examined for the murmur and any other heart sound that may provide valuable information. Conclusion: Every clinician especially in the low-resource setting should be aware of this potentially fatal mechanical complication as the mortality remains significantly high. Early prompt diagnosis and treatment is the key of achieving an optimal outcome.

scholarly journals Transcatheter closure of post myocardial Infarction ventricular septal rupture with the Amplatzer Septal occluder

2021 ◽  
Vol 18 (2) ◽  
pp. 65-68
Author(s):  
Chandra Mani Adhikari ◽  
Manish Shrestha ◽  
Birat Timalsina ◽  
Amrit Bogati ◽  
Madhu Rokka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention ◽  
Transcatheter Closure ◽  
Amplatzer Septal Occluder ◽  
Ventricular Septal Rupture ◽  
Surgical Closure ◽  
Amplatzer Device ◽  
Life Threatening ◽  
Life Threatening Complication

Ventricular septal rupture is a rare yet life threatening complication of acute myocardial infarction. Surgical closure is the treatment of choice however despite surgical intervention mortality remains high.  Transcatheter closure of ventricular septal rupture has emerged as a new alternative strategy which is less invasive potentially allowing early hemodynamic stabilization. We report a case of a 60-year-old male with post infarction ventricular septal rupture who was treated with percutaneous closure using an Amplatzer device at Shahid Gangalal National Heart Centre, Nepal. 

scholarly journals Epidemiology of Post-Infarction Ventricular Septal Rupture in Patients Undergoing Surgical Repair at Different Times from the Development of Acute Myocardial Infarction

2021 ◽  
pp. 18-25
Author(s):  
Ramil A. Aliyev ◽  
Yelizaveta O. Lebedieva ◽  
Mykhailo M. Grusha ◽  
Kamran K. Musayev
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Surgical Intervention ◽  
Rapid Development ◽  
Myocardial Reperfusion ◽  
Time Interval ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Leading Role ◽  
Artery Disease

Introduction. The article is dedicated to the epidemiological aspects of the mechanical complication of acute myocardial infarction (AMI), particularly post-infarction ventricular septal rupture (VSR), problematic issues of its etiology and localization. Mortality of such patients is determined by rapid development of hemodynamic disorders and their severity, unpredictable clinical course, and the difficulty of early diagnosis. In addition, the high mortality rate of patients, especially when correcting the ventricular septal defect at the early stages after AMI, leaves open the question of the tactics of surgical treatment. The influence of certain risk factors of ischemic heart disease (IHD) on the development of post-infarction VSR is also considered. The aim. To study the epidemic features of post-infarction VSR in patients with different terms of surgical intervention after the development of AMI. Materials and methods. This study presents a retrospective analysis of 90 patients with coronary artery disease complicated by post-infarction VSR, who underwent surgical intervention for the period 2002-2019. The ages of hospitalized patients with post-infarction VSR ranged from 29 to 81 years. All the patients were divided into 3 groups depending on the time interval from AMI to surgical intervention. Results and discussion. It was found that post-infarction VSR is more common in men in the age range of 45-74 years after the manifestation of the first transmural AMI. More than a half of post-infarction VSR cases (56.7%) are associated with anterior localization of the ruptures in consequence of anterior AMI. Since the leading role in the treatment of AMI belongs to percutaneous coronary interventions (PCI), we analyzed the use of various reperfusion techniques to restore coronary blood flow in patients with post-infarction VSR. The analysis suggests that there are no statistically significant differences between the studied groups of patients with post-infarction VSR who underwent myocardial reperfusion (p = 0.103). Conclusions. The presence of chronic renal failure (CRF) in patients in the early post-infarction period can complicate the course of post-infarction VSR and affect perihospital mortality. The absence or untimeliness of myocardial reperfusion increases the risk of developing this complication of AMI. The ambiguous prognosis of treatment of post-infarction VSR makes a serious problem for clinicians.

scholarly journals Ventricular Septal Rupture Secondary to Myocardial Infarction Post Fibrinolytic Therapy: A Case Report

2019 ◽  
Author(s):  
Ankitha Peetha ◽  
Nahida Farheen Shaik ◽  
Spandana Ayela
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Mortality Rate ◽  
High Mortality ◽  
Anterior Wall ◽  
Fibrinolytic Therapy ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Surgical Emergency

Myocardial infarction can be complicated by Ventricular septal rupture which is a rare fatal grim mechanical complication of MI which is a surgical emergency due to its incredibly high mortality rate. We depict a case of Anterior wall MI which was complicated by Ventricular septal rupture post fibrinolytic therapy.

scholarly journals Case of ventricular septal rupture following acute myocardial infarction

Ultrasound ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 196-201
Author(s):  
Natasha M Amorosi ◽  
Alison White
Keyword(s):  
Myocardial Infarction ◽  
Point Of Care ◽  
Initial Point ◽  
Signs And Symptoms ◽  
Adverse Outcomes ◽  
Point Of Care Ultrasound ◽  
Ventricular Septal Rupture ◽  
Long Term Outcomes

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.

scholarly journals Surgical Treatment of Ventricular Septal Defect Following Myocardial Infarction: A Case Report

Medicina ◽  
2013 ◽  
Vol 49 (4) ◽  
pp. 32
Author(s):  
Eglė Ereminienė ◽  
Rūta Jurgaitienė ◽  
Rimantas Benetis ◽  
Giedrė Bakšytė ◽  
Giedrė Stanaitienė
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Elective Surgery ◽  
Mechanical Complication ◽  
Aggressive Approach ◽  
Surgical Closure ◽  
Intra Aortic Balloon Pump ◽  
Life Threatening ◽  
Prompt Diagnosis

Ventricular septal defect after myocardial infarction is a rare but often life-threatening mechanical complication. The keys of management are a prompt diagnosis of ventricular septal defect and an aggressive approach to stabilize patient’s hemodynamics. Invasive monitoring, judicious use of inotropes and vasodilators, and an intra-aortic balloon pump are recommended for the optimal support of patient’s hemodynamics. The best results are achieved if optimally medically managed patients survive at least 4 weeks before elective surgery necessary for scar formation in a friable infarcted tissue. We report a case of acute myocardial infarction complicated by the rupture of ventricular septum. Instead of attempting an immediate surgical closure of ventricular septal defect, the postponed surgery was successfully performed 3 weeks after the occurrence of ventricular septal defect. Preoperatively, clinical and hemodynamic conditions of the patient were maintained stable with the support of an intra-aortic balloon pump and inotropes.

scholarly journals Ventricular septal rupture presented with chronic heart failure symptoms: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Ioannis Michelis ◽  
Ioannis Kontonasakis ◽  
Christina Tsakliadou ◽  
Nikolaos Kouvelas
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mortality Rate ◽  
High Mortality ◽  
Medical Attention ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Elective Repair ◽  
Very High

Abstract Background Ventricular septal rupture (VSR) is a rare mechanical complication following acute myocardial infarction, with very high mortality rate. Haemodynamic deterioration and cardiogenic shock is common in such cases. Rarely, however, patients may show only signs of chronic heart failure or be completely asymptomatic. Case summary We report a case of a 72-year-old male patient with VSR following a transmural myocardial infarction. He sought medical attention only after gradually experiencing symptoms of chronic heart failure, weeks after the onset of the myocardial infarction. The patient successfully underwent elective repair surgery, after optimizing the medical therapy and completing the necessary workup. Discussion Ventricular septal rupture repair is necessary in all cases due to the high mortality rate if left untreated. The timing of the operation, however, should be decided individually for every patient. Haemodynamically unstable patients may require early surgery, but in stable patients responding to medical treatment, delayed repair may be the best option.

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