title: Complex ventricular septal rupture with dissection of the right ventricular wall in ischemic context.
abstract: A 72-year-old man was admitted to the local hospital with non-ST elevation myocardial infarction. In the first 24 hours, a new onset apical murmur was heard. Transthoracic and transesophageal echocardiography showed interventricular septal (IVS) rupture and dissection of the right ventricle (RV) wall forming an echolucent pseudocavity that partially occupied the RV and communicated with the true RV cavity. Multislice computed tomography characterized in detail the IVS and RV wall dissection, and further showed the right coronary artery in the outer border of the RV and pseudocavity, excluding pericardial fluid. Despite surgical correction, progression to cardiogenic shock and death occurred 33 days after admission.
authors.affiliation: Cardiovascular Interventional Unit, Department of Cardiology, Gaia Hospital Center, Vila Nova de Gaia, Portugal. gpmorais@gmail.com
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pires de Morais
authors.forename: Nelson
authors.initials: N
authors.lastname: Paulo
authors.forename: Miguel Silva
authors.initials: MS
authors.lastname: Vieira
authors.forename: Francisco
authors.initials: F
authors.lastname: Sampaio
authors.forename: Nuno
authors.initials: N
authors.lastname: Bettencourt
authors.forename: Sofia
authors.initials: S
authors.lastname: Cabral
authors.forename: José
authors.initials: J
authors.lastname: Ribeiro
authors.forename: Conceição
authors.initials: C
authors.lastname: Fonseca
authors.forename: Severo
authors.initials: S
authors.lastname: Torres
authors.forename: Luís
authors.initials: L
authors.lastname: Vouga
authors.forename: Vasco
authors.initials: V
authors.lastname: Gama
mesh_terms: D000368:Aged; D004452:Echocardiography; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D018658:Ventricular Septal Rupture / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery