Acute mechanical complications in patients suffering from acute myocardial infarction

Formica, Francesco; Mariani, Silvia; D’Alessandro, Stefano

doi:10.20517/2574-1209.2019.19

Cited by 5 publications

(3 citation statements)

References 41 publications

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“…Mechanical complications occur at a rate of about 3 per 1000 patients with acute MI, and most of these events are detected in patients with STEMI. Among these patients, ventricular septal rupture is the most common and occurs with a frequency of about 1 in 1000, free wall rupture is the least common [10]. An intracardiac shunt is hemodynamically significant if: there is evidence of cavity enlargement, and/or evidence of sustained Qp:Qs ≥1.5:1.…”

Section: Discussionmentioning

confidence: 99%

Multi-modality assessment of mechanical complications in a patient with inferior myocardial infarction – Case Report

Espínola‐Zavaleta¹,

Berarducci²,

Luna-Alvarez-Amézquita³

et al. 2021

Clin Res Trials

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Section: Discussionmentioning

confidence: 99%

Multi-modality assessment of mechanical complications in a patient with inferior myocardial infarction – Case Report

Espínola‐Zavaleta¹,

Berarducci²,

Luna-Alvarez-Amézquita³

et al. 2021

Clin Res Trials

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“…Treatment of post-MI VSD is challenging. The timing of intervention and the treatment approach continues to be an area of debate, depending on the type and size of the defect, clinical condition of the patient, and technical expertise [ 8 - 10 ]. Surgical management has been the standard treatment.…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication of Myocardial Infarction: Ventricular Septal Defect

Elkattawy¹,

Alyacoub²,

Noori³

et al. 2020

Cureus

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Ventricular septal defect (VSD) is a rare but lethal complication of myocardial infarction. We present a case of a 65-year-old male who presented with a history of progressive shortness of breath associated with productive cough. Physical examination was significant for crepitation in both lower lung fields and bilateral lower extremity edema. Chest X-ray revealed bilateral reticular opacities with small bilateral pleural effusions. Polymerase chain reaction (PCR) for COVID was positive. Echo showed a left ventricular ejection fraction (LVEF) of 30-35%, ischemic cardiomyopathy, and muscular ventricular septal defects with left to right shunting and severely elevated pulmonary artery systolic pressure. Overtime during the hospital course, he developed respiratory and fulminant hepatic failure. Our patient had VSD due to an undiagnosed old myocardial infarction (MI). Initially heart failure was compensated and treated with medical management. Later on, he developed respiratory complications related to COVID-19 infection as well as hepatic failure in addition to a cardiomyopathy which made him a poor surgical candidate leading to death.

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“…Left ventricular free wall rupture (LVFWR), and Inter-ventricular septal rupture (VSR) are major mechanical complications after acute myocardial infarction (AMI). The incidence of post-infarction LVFWR ranges from 2-6.2% (1) of AMI with an in-hospital mortality rate of 80% (2) . Post AMI VSR has an incidence of 0.25% (3) .…”

Section: Introductionmentioning

confidence: 99%

Up against the wall - emergency double myocardial rupture repair

Ravi

Sinha

Dunlop

et al. 2023

Preprint

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Background Left ventricular free wall rupture (LVFWR) and interventricular septal rupture (VSR) are potentially catastrophic mechanical complications after acute myocardial infarction (AMI). When they occur together, “double myocardial rupture” (DMR), survival is unlikely. DMR is seen in only 0.3% of all AMIs. With or without surgical intervention, the odds are against the patient. Case presentation A 57-year-old male self-referred to the emergency department of a remote hospital 5 days after first experiencing chest pain. Investigations in ED confirmed an inferior ST-segment elevation myocardial infarction (STEMI) complicated by DMR. Coronary angiography revealed a mid-course total occlusion of the right coronary artery (RCA). He was rapidly transferred to our regional cardiac surgical unit, arriving straight into the operating theatre, in cardiogenic shock. He was briefly conscious, before arresting prior to intubation and being massaged onto bypass. Not only did he survive the all-night operation, requiring a mitral valve replacement in the process, but he survived multiple postoperative complications to be eventually transferred on postoperative day 66, neurologically intact, to a peripheral unit to complete his rehabilitation. He was subsequently discharged home 88 days after the operation and was able to ambulate with a walking frame into his first postoperative follow-up clinic appointment. Conclusions Our patient, against all odds, has survived DMR and multiple postoperative complications. We present the details of his case and the literature surrounding the condition. The patient’s mental fortitude and his supportive family played a big part, along with excellent team working in our unit.

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Acute mechanical complications in patients suffering from acute myocardial infarction

Cited by 5 publications

References 41 publications

Multi-modality assessment of mechanical complications in a patient with inferior myocardial infarction – Case Report

Multi-modality assessment of mechanical complications in a patient with inferior myocardial infarction – Case Report

A Rare Complication of Myocardial Infarction: Ventricular Septal Defect

Up against the wall - emergency double myocardial rupture repair

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