Ventricular septal rupture during ibuprofen therapy for pericarditis after acute myocardial infarction

Abstract

During the last 16 months, we encountered 4 patients who developed ventricular septal defect (VSD) during acute myocardial infarction (AMI), and 3 of them were receiving ibuprofen therapy for concomitant pericarditis. Retrospective review of our patients with AM1 between 1976 and 1984 yielded 5 more patients with pericarditis during AM1 in whom ventricular septal rupture developed; only 1 of the 5 was receiving concomitant treatment with an antiinflammatory agent (salicylates). Brown et al1 reported a high incidence of left ventricular transmural scar thinning in ibuprofentreated, anesthetized, open-chest dogs who underwent a proximal left anterior descending coronary artery occlusion for 6 weeks. Brown et al hypothesized that ibuprofen treatment may have facilitated infarct expansion by interfering with collagen deposition during the early “healing phase” of the AMI. Because the use of ibuprofen has become increasingly widespread in the treatment of idiopathic and viral pericarditis, we wish to alert clinicians to the possible detrimental effect of ibuprofen for therapy of pericarditis during AMI.