Asymptomatic ventricular septal rupture following inferior wall myocardial infarction

Abstract

A 60-year-old male was diagnosed as having inferior wall myocardial infarction 20 days back before admission to our tertiary care institute. He was referred to us for evaluation. Patient was not having any chest pain & was hemodynamically stable on admission to our centre. Patient was found to have ventricular septal defect in basal septum with left to right shunt through the defect. Coronary angiogram revealed single vessel disease (RCA). Although ventricular septal rupture following MI, are mostly symptomatic due to altered hemodynamics, heart failure or systemic desaturation if large; but our patient was asymptomatic surprisingly. As post MI ventricular septal rupture can progress at any point of time, closure is the treatment of choice-either surgical or percutaneous. Our patient underwent CABG with surgical closure as in our centre we usually do surgical closure of post MI VSRs. Patient is doing well on follow up.