Septal rupture with right ventricular wall dissection after myocardial infarction.
BACKGROUND
In patients with inferior myocardial infarction, septal rupture generally involves basal inferoposterior septum, and the communicating tract between left and right ventricle is often serpiginous with a variable degree of right ventricular wall extension. Right ventricular wall dissection following septal rupture related with previous myocardial infarction has been reported in a very few cases, in many of them this condition has been diagnosed in post-mortem studies. In a recent report long-term survival has been achieved after promptly echocardiographic diagnosis and surgical repair.


METHODS
We present a case of a 59-year-old man who had a septal rupture with right ventricular wall dissection after inferior and right ventricular myocardial infarction. Transthoracic echocardiography, as first line examination, established the diagnosis, and prompt surgical repair allowed long-term survival in our patient.


CONCLUSIONS
Outcomes after right ventricular intramyocardial dissection following septal rupture related to myocardial infarction has been reported to be dismal. Early recognition of this complication using transthoracic echocardiography at patient bedside, and prompt surgical repair are the main factors to achieve long-term survival in these patients.
Soriano
Carlos J
CJ
Department of Cardiology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain. cjsorian@comv.es
Pérez-Boscá
José L
JL
Canovas
Sergio
S
Ridocci
Francisco
F
Federico
Pau
P
Echanove
Ildefonso
I
Paya
Rafael
R
D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery