Simultaneous Left Ventricular Pseudo-Aneurysm and Ventricular Septal Rupture After a Non-ST Segment Myocardial Infarction

Abstract

The incidence of myocardial rupture following an acute coronary syndrome has dramatically decreased with the implementation of early reperfusion strategies. High clinical suspicion is critical for early recognition and appropriate management of myocardial mechanical complications. Here we present an uncommon combination of left ventricular pseudo-aneurysm and ventricular septal rupture complicated with coronary sinus shunting following a non-ST elevation myocardial infarction, where modern echocardiography allowed prompt and accurate identification of the event.

Concomitant ventricular septal rupture and interventricular septal aneurysm in neglected inferior myocardial infarction misdiagnosed with congenital ventricular septal defect: A case report

“…Early reperfusion strategies have significantly reduced the rate of cardiac ruptures, including VSR, following acute MI during the recent years. 2 Although reperfusion therapy has dramatically decreased the incidence of these complications, the occurrence of these complications is still associated with poor outcomes and high mortality rates. For instance, the mortality rate of post‐MI VSR, despite surgical treatments, ranges between 40% and 75%.…”

“… 1 Although timely reperfusion therapy can dramatically decrease the incidence of these complications, the occurrence of these complications is associated with poor clinical outcomes. 2 …”

Concurrent true inferoposterior left ventricular aneurysm and ventricular septal rupture secondary to inferior myocardial infarction: a case report

“… 7 , 8 Recently, several cases of inferoposterior ventricular aneurysm complicating AMI have been reported, with no concurrent VSR. 9–11 Davila et al 12 reported a case of combined inferior pseudo-aneurysm and VSR after a non-ST segment MI. Chan et al 13 reported two cases of right ventricular intramyocardial dissection with a left-to-right shunt post-MI.…”