Post-infarction ventricular septal rupture combined with acute right ventricular infarction. A case report

An elderly White woman suffering from an acute transmural inferior myocardial infarction, with possible true posterior extension, is presented. Her holosystolic cardiac murmur and hypotension are attributed to rupture of the interventricular septum which occurred between the 2nd and 3rd days after infarction. Strong evidence for concomitant right ventricular infarction is put forward and therapy is discussed. As far as the authors can determine, this combination of cardiac lesions has not been documented ante mortem previously. The apparent beneficial use of intravenous hydrallazine, for the first time in right ventricular infarction, is discussed.