A mechanical complication of acute myocardial infarction: Ventricular septal defect

Abstract

Introduction The ventricular septal defect (VSD) incidence today is less than 1%. It presents with a rapid clinical deterioration and acute heart failure. A loud systolic murmur appears over the precordium. Doppler echocardiography is the golden standard for diagnosis. Case Report A female patient was admitted to the hospital with the diagnosis of an acute myocardial infarction with the involvement of the inferior wall and right ventricle. At admission, a loud systolic murmur above the precordium was noted and an emergency echocardiography was performed. A suspected interruption of the interventricular septum continuity was registered at the inferoseptal level. An emergency coronography was immediately performed to uncover a subocclusion of the medial segment of the right coronary artery. Ventriculography was performed in the same act and passage of contrast was registered from the left ventricle to the right at the septal level. A cardiac surgeon was consulted, but the patient died while being prepared for surgery. Conclusion Keeping in mind the high mortality rate, a prompt diagnosis and aggressive treatment with a timely surgical intervention are necessary to enable a favorable outcome. Poor prognosis parameters are advanced age and a myocardial infarction involving the inferior wall, which were both present in our patient.

Keywords

• mechanical complication
• acute myocardial infarction
• ventricular septal defect