Delayed ventricular septal rupture after percutaneous coronary intervention in acute myocardial infarction.
In the era before reperfusion therapy, ventricular septal rupture complicated 1approximate3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the mid-portion of the left anterior descending artery (LAD), and the lesion was successfully treated by percutaneous coronary intervention (PCI) with stent implantation. After PCI, the anterior wall motion improved on the follow-up echocardiogram. However, on the 20th hospital day, the patient condition deteriorated suddenly with pulmonary congestion. The echocardiography revealed a 1.3 cm ventricular septal defect at the apical septum with a left-to-right shunt. We report this rare case of delayed septal rupture in a patient with patent LAD after PCI and recovery of wall motion.
Park
Ji Young
JY
Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
Park
Seong Hoon
SH
Oh
Ji Young
JY
Kim
In Je
IJ
Lee
Yu Hyun
YH
Park
Si Hoon
SH
Kwon
Ki Hwan
KH
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006346:Heart Septum / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000601:surgery; D015607:Stents; D013997:Time Factors; D018658:Ventricular Septal Rupture / Q000209:etiology*