Post-acute Myocardial Infarction Complication: A Ventricular Septal Defect

A ventricular septal defect (VSD) is usually a congenital cardiac condition. In the elderly, although it may be present from birth, VSD can be acquired and manifest as a complication of acute myocardial infarction (AMI), as endocarditis, or as a result of cardiac procedures. It can lead to heart failure and other severe consequences demanding medical intervention. This case study describes an 80-year-old obese woman who was diagnosed with inferolateral myocardial infarction with right ventricular (RV) involvement after being admitted with symptoms of acute coronary syndrome (ACS). VSD, a rare mechanical complication, was identified as a contributing factor to hemodynamic instability. The patient underwent percutaneous coronary intervention (PCI) to revascularize the occluded right coronary artery (RCA). Hemodynamic support with norepinephrine and levosimendan, along with mechanical ventilation, was crucial for stabilization. Transfer to a tertiary care facility with cutting-edge surgical skills was essential. This example emphasizes how challenging it can be to manage AMI in elderly people, particularly when unusual side effects like VSD occur. It also highlights how important a multidisciplinary approach is to improving outcomes and optimizing care.