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Ventricular septal rupture with "normal" coronary arteries
1Department of Cardiovascular Surgery, St. Margaret's Hospital, Montgomery, Alabama, USA.
Texas Heart Institute Journal
|March 1, 1985
Summary
A rare case of ventricular septal rupture occurred despite normal coronary arteries, likely due to septal artery issues. This complication led to severe right ventricular dysfunction and death post-surgery.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Pathology
Background:
- Ventricular septal rupture (VSR) is a serious complication following myocardial infarction.
- While often associated with significant coronary artery disease, VSR can occur in atypical presentations.
Purpose of the Study:
- To report a unique case of VSR in a patient with normal coronary arteries.
- To explore potential etiologies for VSR in the absence of obstructive coronary disease.
Main Methods:
- Case report of a 73-year-old female patient.
- Clinical presentation including acute anteroseptal infarction, cardiac murmur, and low cardiac output.
- Diagnostic cardiac catheterization and surgical intervention for VSR closure.
Main Results:
- Cardiac catheterization revealed a large, high ventricular septal defect.
- Coronary arteries were found to be normal.
- Successful VSR closure was achieved, but the patient experienced fatal right ventricular dysfunction.
Conclusions:
- Ventricular septal rupture can occur even with normal major coronary arteries.
- Spasm or isolated atherosclerotic disease of a septal perforator artery is a potential cause.
- Right ventricular dysfunction remains a critical factor in post-VSR surgical outcomes.