A case of atrial septal defect complicating myocardial infarction. Severe heart failure induced by balloon occlusion of ASD.
A 58 year old man with an acute, extensive anterior myocardial infarction was found to also have an atrial septal defect secundum. A cardiac catheterization study showed a large left to right shunt (Qp/Qs: 6.0). Since other clinical findings were not consistent with the prolonged existence of a large shunt, we considered it to be secondary to the myocardial infarction. Balloon occlusion of the ASD was carried out to predict the hemodynamics after the surgical correction, which soon resulted in severe left ventricular failure. Therefore, an operation was not feasible in this case.
D006328:Cardiac Catheterization; D004562:Electrocardiography; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D012018:Reflex / Q000502:physiology