Normal coronary myocardial infarct is innocent or guilty? A case of ventricular septal rupture secondary to normal coronary myocardial infarction

Abstract

Prognosis of cases of myocardial infarction with normal coronary arteries (MINCA) is known to be better than acute myocardial infarction cases with obstructive coronary lesions. A MINCA case causing ventricular septal rupture is rare. Herein, we present a 70-year-old female MINCA case which caused ventricular septal rupture which is a fatal complication of acute myocardial infarction. <Learning objective: Acute myocardial infarction, whether it is atherosclerotic or non atherosclerotic, has a high mortality rate when complicated with ventricular septal rupture. Complications of acute myocardial infarction should be observed cautiously and specific risk factors for ventricular septal rupture need to be investigated.>

Endovascular closure of MINOCA-caused ventricular septal defect (VSD)

“…After meticulous research, we found only 10 published cases of MINOCA-caused VSDs. [4][5][6][7][8][9][10][11][12][13] All of them treated surgically with an overall survival rate of 60%. We did not find a case of post-MINOCA VSD treated by percutaneous approach.…”

Myocardial infarction with non obstructive coronary arteries complicated with ventricular septal rupture: A case report and literature review

“…11 To our knowledge, this is one of the very few case reports in the literature of a patient suffering an acute coronary syndrome with normal coronary arteries and subsequent VSR 24 h after catheterization and 30 h after hospital admission. [11][12][13][14][15] Possible explanations for the VSR after the acute coronary event may be either spasm or plaque erosion (more common in NSTEMI, younger age and absence of the 'traditional' cardiovascular risk factors) or paroxysmal atrial fibrillation, that led to transient epicardial thrombosis and/or occlusion or an ostial and isolated occlusion of a large septal perforator that could not be visualized during the coronary angiography procedure.…”

Posterobasal left ventricular aneurysm after myocardial infarction with normal coronary arteries: Case-report

“…Cortell et al[ 2 ] also state that the overall prognosis for such cohort of patients was considered good. However, some authors mention life-threatening mechanical MINCA complications including subepicardial aneurysm associated with ventricular septal perforation or ventricular septal rupture[ 9 , 10 ].…”