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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Late-Presenting Myocardial Infarction With PCI and Impella Placement Complicated by Ventricular Septal Defect and
Zaheen Hossain1, Tai Metzger1, Abdullah Jalal1
1Department of Foundational Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
None:
Post-myocardial infarction ventricular septal defect (VSD) is a rare but frequently fatal mechanical complication. We report a 67-year-old man who presented approximately 48 hours after symptom onset with dyspnea and was diagnosed with an ST-segment elevation myocardial infarction. He underwent emergent percutaneous coronary intervention supported by Impella placement but subsequently developed a large ventricular septal defect two days later, complicated by Impella malfunction. The patient ultimately underwent successful surgical repair. This case highlights the importance of maintaining a high index of suspicion for mechanical complications in late-presenting myocardial infarction, even after apparent stabilization with revascularization and mechanical circulatory support.
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