Acute myocardial infarction complicated with ventricular septal rupture and intracranial hemorrhage

Echocardiography. 2018 Apr;35(4):559-562. doi: 10.1111/echo.13824. Epub 2018 Feb 8.

Abstract

Ventricular septal rupture (VSR) is a rare but fatal complication of acute myocardial infarction (AMI) with an associated mortality that ranges from 41% to 80%. The treatment consists of supplemental oxygenation, afterload reduction, intraaortic balloon pump, and surgical repair. In selected patients, extracorporeal membrane oxygenation (ECMO) and/or percutaneous closure of the defect can be considered if anatomically appropriate. Echocardiography evaluates the morphology and location of the defect, anatomical concerns for percutaneous closure, and accompanying pathologies. We present a 48-year-old man with inferior myocardial infarction and basal VSR who was not a candidate for percutaneous closure. Surgery was planned, but he died from extensive subarachnoid and intracranial hemorrhage.

Keywords: acute myocardial infarction; ventricular septal rupture.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Echocardiography / methods
  • Echocardiography, Transesophageal / methods
  • Fatal Outcome
  • Humans
  • Intracranial Hemorrhages / complications*
  • Intracranial Hemorrhages / diagnostic imaging*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnostic imaging*
  • Risk Factors
  • Tomography, X-Ray Computed
  • Ventricular Septal Rupture / complications*
  • Ventricular Septal Rupture / diagnostic imaging*