Ventricular Septal Rupture Complicating Acute Myocardial Infarction: Interesting Case and Review

Abstract

Man of 72 years old, smoking, who presented acute myocardial infarction with ST-segment elevation (STEMI) localized in anterior wall (Figure 1) and included into the code infarction protocol at emergency room of cardiology hospital in Mexico City-IMSS. The patient was successful re-perfused by percutaneous coronary intervention of left anterior descending artery, documenting several other non-critical coronary artery disease. During its evolution in the first twelve hours, it was identified an apical ventricular septal rupture documented by echocardiogram. (Figure 2) Medical management was implemented. After stabilization patient ask voluntary discharge of hospital, 10 days later he come back due to severe heart failure. He was stabilized again and submitted to surgical reparation (Figure 3 and Figure 4) later and his heart failure was successfully resolved (Figure 4) and he was discharged in an excellent condition. We present a case and review of the literature as well as the position of management of this group of patients in the Hospital’s cardiology of the National Medical Center SXXI, IMSS-México, since it is currently still controversy.