title: Impact of cardiac magnet resonance imaging on management of ventricular septal rupture after acute myocardial infarction.
abstract: A 74-year-old man was admitted to the cardiac catheterization laboratory with acute myocardial infarction. After successful angioplasty and stent implantation into the right coronary artery, he developed cardiogenic shock the following day. Echocardiography showed ventricular septal rupture. Cardiac magnet resonance imaging (MRI) was performed on the critically ill patient and provided detailed information on size and localization of the ruptured septum by the use of fast MRI sequences. Moreover, the MRI revealed that the ventricular septal rupture was within the myocardial infarction area, which was substantially larger than the rupture. As the patient's condition worsened, he was intubated and had intra-aortic balloon pump implanted, and extracorporeal membrane oxygenation was initiated. During the following days, the patient's situation improved, and surgical correction of the ventricular septal defect could successfully be performed. To the best of our knowledge, this case report is the first description of postinfarction ventricular septal rupture by the use of cardiac MRI in an intensive care patient with cardiogenic shock and subsequent successful surgical repair.
authors.affiliation: Tobias Gassenmaier, Meinrad Beer, Department of Radiology, University Hospital Wuerzburg, 97080 Wuerzburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Gassenmaier
authors.forename: Armin
authors.initials: A
authors.lastname: Gorski
authors.forename: Ivan
authors.initials: I
authors.lastname: Aleksic
authors.forename: Nikolas
authors.initials: N
authors.lastname: Deubner
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
authors.forename: Meinrad
authors.initials: M
authors.lastname: Beer
keywords: Cardiac magnetic resonance imaging; Extracorporeal membrane oxygenation; Myocardial infarction; Ventricular septal rupture; surgical repair