Doppler echocardiographic features of ventricular septal rupture in myocardial infarction

Abstract

Doppler echocardiography was used to evaluate the features of interventricular septal rupture in six patients with acute myocardial infarction and to substantiate the hemodynamic data and morphologic findings at surgery or autopsy. Although echocardiographic visualization of the septal rupture was obtained in only two of the six patients, unusual Doppler flow signals were detected in the apical portion of the right ventricle in all six patients. Five patients had unusual flow signals during both systole and diastole; one had such signals only during systole. The location of these unusual flow signals coincided with the site of septal rupture confirmed at surgery or autopsy. The pattern of the flow signals in one cardiac cycle was very similar to that of the pressure difference between the left and right ventricular cavities. These findings indicate that the unusual flow signals represent the left to right shunt flows resulting from septal rupture. In conclusion, Doppler echocardiography may be a very useful tool for diagnosing interventricular septal rupture easily and noninvasively in patients with acute myocardial infarction.

Ventricular septal rupture complicating acute myocardial infarction following percutaneous coronary intervention

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“…[10][11][12] Aortic regurgitation was considered mild if the signals were recorded only from localized area in the left ventricular outflow just below the aortic valve; aortic regurgitation was considered moderate when the signals extended to the level of the tip of the anterior leaflet of the mitral valve; it was severe when the signals extended well into the apical portion of the left ventricular cavity. [13][14][15] Aortic valve regurgitation was assessed from the ratio of aortic regurgitate width to left ventricular outflow tract width. Valve regurgitation including the mitral, aortic and tricuspid valves was graded as 1 (mild), 2 (moderate) or 3 (severe).…”