Acute myocardial infarction with multiple mechanical complications

Abstract

The rupture of the inter-ventricular septum is a rare, but extremely severe mechanical complication of the acute myocardial infarction, which in most cases of no immediate surgery is fatal (30 days death rate – 80%). The incidence of the septum ventricular defect post-acute myocardial infarction was 1-3% in the period before crash injury therapy, dropping to 0.2% after introducing the thrombolytic treatment. The acute mitral failure and the septum ventricular defect are two mechanical complications of the acute myocardial infarction associated with high death rate, regardless of the progress made in medical and surgery therapeutic approach. This paper highlights the peculiarities of a clinical case like the acute myocardial infarction as the first manifestation of heart disease in a patient with no history of cardiovascular disease but with risk factors (obesity, dyslipidemia, hypertension), the ECG evident changes in the anterior territory and more discrete in the inferior territory, which established the initial diagnosis to be myocardial infarction and the presence of two mechanical threatening complications: ventricular septal flaw and acute mitral failure through posterior papillary muscle incomplete rupture.