Post myocardial infarction ventricular septal rupture in a patient with single coronary artery

Area of Science:

• Cardiology
• Cardiac Surgery
• Interventional Cardiology

Background:

• Ventricular septal rupture (VSR) is a rare but serious complication following acute myocardial infarction (AMI).
• The incidence of VSR has decreased with timely reperfusion therapy for AMI.
• VSR typically occurs in patients with multivessel coronary artery disease.

Observation:

• A 52-year-old male presented with VSR on the third day post-anterior wall AMI.
• Coronary angiography revealed a rare single coronary artery anomaly, originating from the left main stem.
• Significant stenotic lesions were identified in the left anterior descending and left circumflex coronary arteries.

Findings:

• The co-occurrence of VSR and a single coronary artery anomaly (right coronary artery arising from the left main stem) with significant coronary artery disease is unprecedented.
• This case highlights a unique anatomical variation in a patient with a life-threatening cardiac complication.

Implications:

• This case expands the understanding of coronary artery anomalies and their potential association with myocardial infarction complications.
• It underscores the importance of comprehensive coronary angiography in patients with complex cardiac events, especially when anatomical variations are suspected.
• Further investigation may be warranted to determine the specific pathophysiological mechanisms linking single coronary artery anomalies to increased VSR risk post-MI.