Abstract
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.
Highlights
Ventricular septal rupture (VSR) is a rare complication of ST-elevation myocardial infarction (STEMI), typically discovered post-revascularization.Case report: We 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
A delayed surgical VSR repair, with concomitant coronary artery bypass grafting, was implemented for definitive management. This case highlights the utility of POCUS in a STEMI patient with a suspected mechanical complication. [Clin Pract Cases Emerg Med. 2020;4(3):407–410.]
Development of VSR is thought to be mediated by the complete occlusion of a major vessel in the absence of spontaneous reperfusion or collateral circulation
Summary
Section Editor: Scott Goldstein, MD Submission history: Submitted February 25, 2020; Revision received April 21, 2020; Accepted April 24, 2020 Electronically published June 15, 2020 Full text available through open access at http://escholarship.org/uc/uciem_cpcem DOI: 10.5811/cpcem.2020.4.47073
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call