title: A rare long-term survival of the life-threatening trio: silent myocardial infarction complicated by ventricular septal rupture, type 2 diabetes mellitus and chronic bronchitis.
abstract: Silent myocardial infarction followed by ventricular septal rupture (VSR) is a rare phenomenon. In the absence of a timely diagnosis and surgical correction, the short term mortality of such patients is greater than 90%. We present one such unique case of a patient with an asymptomatic myocardial infarction complicated by VSR, type 2 diabetes mellitus and chronic bronchitis. Unfortunately, this possibly life-threatening condition had been misdiagnosed for more than one month after initial medical contact. Lack of typical symptoms of chest pain and chronic bronchitis is primarily responsible for this long-time misdiagnosis. We want to emphasize the importance of systematic diagnostic work-up, high vigilance for possibility of VSR complicating myocardial infarction in aged patients with diabetes and chronic bronchitis, which may mislead doctors' judgments and put patients at high risk.
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Md Abdur Rob
authors.initials: MA
authors.lastname: Rayhan
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Yong-Ming
authors.initials: YM
authors.lastname: He
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Xiang-Jun
authors.initials: XJ
authors.lastname: Yang
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Bing-Yuan
authors.initials: BY
authors.lastname: Zhou
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Xu
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Xiao-Jiao
authors.initials: XJ
authors.lastname: Du
authors.affiliation: Division of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Yun-Xia
authors.initials: YX
authors.lastname: Qian
keywords: Silent myocardial infarction; chronic bronchitis; long term survival; misdiagnosis; type 2 diabetes mellitus; ventricular septal rupture (VSR)