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Inferior Wall ST-elevation Myocardial Infarction Complicated by Ventricular Septal Defect and Free Wall

Salma Khatoon1, Michael Goyfman2, Sepideh Nabatian2

  • 1Internal Medicine, Long Island Jewish Forest Hills Hospital, New York, USA.

Cureus
|March 15, 2019
PubMed

Insights

Mechanical complications of myocardial infarction (MI) are rare but serious. This case highlights ventricular septal rupture and myocardial free wall rupture, emphasizing close monitoring post-MI, especially after percutaneous coronary intervention (PCI).

Area of Science:

  • Cardiology
  • Cardiovascular Medicine

Background:

  • Myocardial infarction (MI) management has improved, reducing mechanical complication incidence.
  • Despite advances, complications like ventricular septal rupture (VSR) and free wall rupture can still occur.

Observation:

  • An elderly male with inferior wall MI underwent percutaneous coronary intervention (PCI).
  • He developed a post-infarction VSR and basal inferior wall aneurysm.

Findings:

  • The VSR and aneurysm progressed over three weeks.
  • This culminated in a myocardial free wall rupture with hemopericardium.

Implications:

  • This case underscores the critical need for high suspicion and close monitoring for mechanical complications post-MI, particularly in elderly patients post-PCI.
  • Early detection and management are vital for improving outcomes in these high-risk patients.

Keywords:
complicationsmyocardial infarctionventricular septal rupture

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