Post-infarction ventricular septal rupture with a contained right ventricular pseudoaneurysm formation

Mechanical complication of acute myocardial infarction (MI), such as left ventricular free-wall or septal rupture, pseudo-aneurysm or true aneurysm, are uncommon but potentially fatal conditions, that require an early diagnosis and management. We describe a case of post-infarction ventricular septal rupture with pseudoaneurysm formation included in the right ventricle.

Left ventricular free wall rupture after myocardial infarction: a case report with rare live diagnostic record

Left ventricular free wall rupture is one of the most catastrophic and lethal mechanical complications associated with myocardial infarction. Its diagnosis in a patient still alive is rare, and its only therapeutic option is open surgical treatment. We report the case of an 82-year-old male patient who presented with an acute ST-segment elevation myocardial infarction, within more than 24 hours of onset, in which it was possible to record, in real time, the rupture of the left ventricular free wall by means of ventriculography.

Correlation between the periodontal treatment and ecocardiographic changes in adult dogs

Periodontal disease is commonly diagnosed in dogs and has been associated with systemic lesions in several organs, however, studies correlating this oral condition with heart disease in the canine species are still scarce in the scientific literature. Thus, the objective of the present study was to evaluate such correlation in adult dogs, through serial echocardiographic exams and, nonetheless, to analyze the influence of dental treatment on cardiac function. For this, 60 dogs were used, distributed in two groups, the control (CG, n = 30: presence of periodontal disease, not submitted to oral treatment) and the treated (GT, n = 30: presence of periodontal disease and submitted to oral treatment). The animals of the CG were paired with those of the GT in terms of race, weight, age and degree of periodontal disease. Baseline echocardiographic examinations (D0) of the CG were performed and after 30 days (D30). In GT, examinations were also performed at D0 and D30, however, they were submitted to periodontal treatment after baseline measurements. The echocardiographic exams were performed at the Veterinary Cardiology Laboratory of the Veterinary Hospital of the University of Franca, to record and analyze the interventricular septum in diastole (SIVd), interventricular septum in systole (SIVs), diameter of the left ventricle in diastole (DVEd), left ventricular diameter in systole (EVDs), left ventricular free wall in diastole (PVEd) left ventricular free wall in systole (PVEs) shortening fraction of left ventricle (FS), final diastolic volume (VDF), final stroke volume (VSF), ejection fraction (EF), maximum pulmonary artery pressure gradient (max. GP AP) and left atrial and aortic artery diameter ratio (EA-AO). The results of the CG were statistically compared with those of the GT by means of simple analysis of variance (ANOVA). The data obtained regarding the SIVs, DVEd and PVEs parameters of the GT dogs at D30 showed a statistically significant decrease (p<0.05) when compared to the D30 of the CG. Thus, given the established methodology and the results found, it is possible to infer that periodontal treatment may benefit some cardiac parameters of adult dogs, improving their quality of life and survival.

Successful Low-Dose tPA for Mechanical Mitral Valve Thrombosis in a Patient with Postinfarction Contained Left Ventricular Free Wall Rupture

Prosthetic valve thrombosis is a potentially life-threatening complication diagnosed by a combination of clinical features and imaging modalities, but the optimal management in high bleeding risk patients remains controversial. Current treatment options for prosthetic valve thrombosis included surgery, thrombolytic therapy, and anticoagulation. We present a very unusual case of a patient with a recent ST-elevation myocardial infarction complicated by contained left ventricle free wall rupture and mechanical mitral valve thrombosis. Deemed a high surgical risk candidate, low-dose tissue plasminogen activator was used despite significant bleeding risk from contained left ventricle free wall rupture, which resulted in resolution of the thrombus. To the best of our knowledge, this is the first report of successful thrombolytic therapy for prosthetic mechanical mitral valve thrombosis in a patient with recent postmyocardial infarction contained left ventricular free wall rupture.

Left ventricular false tendons

Left ventricular false tendons (LVFTs) are fibromuscular structures, connecting the left ventricular free wall or papillary muscle and the ventricular septum.There is some discussion about safety issues during intense exercise in athletes with LVFTs, as these bands have been associated with ventricular arrhythmias and abnormal cardiac remodelling. However, presence of LVFTs appears to be much more common than previously noted as imaging techniques have improved and the association between LVFTs and abnormal remodelling could very well be explained by better visibility in a dilated left ventricular lumen.Although LVFTs may result in electrocardiographic abnormalities and could form a substrate for ventricular arrhythmias, it should be considered as a normal anatomic variant. Persons with LVFTs do not appear to have increased risk for ventricular arrhythmias or sudden cardiac death.