title: Double ventricular rupture after acute myocardial infarction: A rare case report.
abstract: A previously asymptomatic 53-year-old male presented 5 days after an acute anterior wall myocardial infarction, who was fibrinolytic naïve, with worsening dyspnea. Transthoracic echocardiographic evaluation revealed rupture of the interventricular septum and pseudoaneurysm of the left ventricle, confirmed by angiography. Coronary angiogram revealed multivessel disease. The patient underwent successful closure of ventricular septal rupture with repair of pseudoaneurysm and saphenous vein grafts to posterior descending branch of right coronary artery and obtuse marginal branch of left circumflex artery. Double ventricular ruptures following acute myocardial infarction are very rare with a reported incidence of 0.3% from various series in the revascularization era. They are also associated with exceedingly high mortality rates reaching up to 50%, even when intervened emergently.
authors.affiliation: Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India. Electronic address: shreetal@gmail.com.
authors.forename: Rajan Nair
authors.initials: RN
authors.lastname: Shreetal
authors.affiliation: Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Kalathingathodika
authors.initials: K
authors.lastname: Sajeer
authors.affiliation: Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Rajasekharan
authors.initials: R
authors.lastname: Sandeep
authors.affiliation: Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Gopalan Nair
authors.initials: GN
authors.lastname: Rajesh
authors.affiliation: Assistant Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Vellani
authors.initials: V
authors.lastname: Haridasan
authors.affiliation: Associate Professor, Department of Cardiovascular and Thoracic Surgery, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sadanadan
authors.affiliation: Professor and Head, Department of Cardiovascular and Thoracic Surgery, Government Medical College, Kozhikode, Kerala, India.
authors.forename: K M
authors.initials: KM
authors.lastname: Kuriakose
authors.affiliation: Professor and Head, Department of Cardiology Government Medical College, Kozhikode, Kerala, India.
authors.forename: Mangalath
authors.initials: M
authors.lastname: Narayanan Krishnan
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*
keywords: Double mechanical rupture; Free-wall rupture; Myocardial infarction; Ventricular septal rupture