title: Delayed ventricular septal rupture complicating anterior wall myocardial infarction.
abstract: A 59-year-old woman was admitted to our hospital with acute pulmonary oedema and cardiogenic shock 35 days after anterior ST elevation myocardial infarction. She developed a new loud pan systolic murmur. Echocardiography revealed a ventricular septal rupture with a significant left to right shunt. She was immediately transferred to the local cardiothoracic unit where she underwent a successful ventricular septal defect (VSD) repair. Ventricular septal rupture often presents within the first 24 hours of acute myocardial infarction and is rare thereafter. It carries a poor mortality (41-80%) even when recognised. Timely recognition of this life-threatening complication can help reduce the resultant morbidity and mortality. Doctors should be aware that this well-recognised complication may present unusually late as in this case.
authors.affiliation: Department of Cardiology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, Essex, UK.
authors.forename: Rajdip
authors.initials: R
authors.lastname: Dulai
authors.affiliation: Department of Cardiology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, Essex, UK.
authors.forename: Aye
authors.initials: A
authors.lastname: Hline
authors.affiliation: Department of Cardiology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, Essex, UK.
authors.forename: Mahvesh Rana
authors.initials: MR
authors.lastname: Javaid
authors.affiliation: Department of Cardiology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, Essex, UK.
authors.forename: Javed
authors.initials: J
authors.lastname: Akhtar
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D018658:Ventricular Septal Rupture / Q000175:diagnosis / Q000209:etiology*