Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction

Kalvin, Lindsey; Yousefzai, Rayan; Khandheria, Bijoy K.; Paterick, Timothy E.; Ammar, Khawaja Afzal

doi:10.1155/2017/9680891

Cited by 5 publications

(12 citation statements)

References 4 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Kafkas

Dragasis

Mantis

et al. 2021

Cathet Cardio Intervent

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Ventricular septal rupture represents one of the most serious complications after an acute coronary syndrome. Nowadays this condition is rare due to early revascularization, but is still associated with high mortality rate. In this case report, we present an unusual case of a woman suffering an acute myocardial infarction with normal coronary arteries complicated with a ventricular septal rupture, which required surgical correction.

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Section: Discussionmentioning

confidence: 99%

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

Kafkas

Dragasis

Mantis

et al. 2021

Cathet Cardio Intervent

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“…However, there have been few reports of post-myocardial infarction ventricular septal dissection forming a septal aneurysm without a shunt [ 5 , 6 ]. Furthermore, to the best of our knowledge, only one case report described a case of a patient who underwent surgical repair of ventricular dissection unaccompanied by a shunt [ 7 ]. This type of pathology is different from other types of post-myocardial infarction complications, such as left ventricular aneurysm or pseudoaneurysms, which we encountered frequently.…”

Section: Discussionmentioning

confidence: 99%

“…In rare cases, a shunt is created by peeling and perforation of the interventricular septum, termed ventricular dissection [ 1 – 4 ]. However, there have been few reports of post-myocardial infarction ventricular septal dissection unaccompanied by a shunt [ 5 – 7 ]. We herein report the case of a patient with post-myocardial infarction ventricular septal dissection forming a septal aneurysm that caused cardiogenic shock.…”

Section: Introductionmentioning

confidence: 99%

Post-myocardial infarction left ventricular septal dissecting aneurysm: a case report

et al. 2021

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Background Post-infarction perforation of the ventricular septum is recognized as a major complication of post-myocardial infarction. However, post-infarction ventricle dissection is seldom reported, as the ventricular shunt often accompanying this condition is a significant cause of cardiogenic shock. We encountered a rare case of ventricular dissection unaccompanied by a shunt, which caused a state of shock. Case presentation A 67-year-old man was diagnosed with acute myocardial infarction with a left ventricular oozing rupture. The occlusion of the left anterior descending artery was aspirated, followed by drainage of the pericardial bleeding and hemostasis of the left ventricle. After 15 h, he presented with sudden cardiogenic shock requiring extra-corporeal membrane oxygenation. The transesophageal echocardiogram showed a left ventricular septal aneurysm. Five days later, he underwent an operation, in which a ventricular septal wall dissection with a tear-forming large pseudoaneurysm was found. The tear was closed with a patch. He was weaned off extra-corporeal membrane oxygenation the next day. Αfter 4 months, he was discharged in a stable condition. Conclusions Recognizing and identifying the cause of cardiogenic shock after myocardial infarction is crucial to provide the best treatment and surgical approach. Ventricular septal dissection should be considered, in addition to the usual complications, such as possible papillary muscle rupture, cardiac rupture, and perforation of the interventricular septum.

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“…However, a few different hypotheses have been proposed. One of the common hypotheses is that after the MI, the blood supply is compromised, especially in the septal perforator arteries [ 3 ]. Septal perforator arteries are vessels that arise from the right coronary and the LAD artery.…”

Section: Discussionmentioning

confidence: 99%

“…Septal perforator arteries are vessels that arise from the right coronary and the LAD artery. The disruption in the blood supply causes opposing forces from the RCA and LAD on the ventricular septum, thereby resulting in the dissection [ 3 ]. The helical myocardial muscular band also plays a significant role in IVSD [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Complete Dissection of the Interventricular Septum Following Myocardial Infarction

Obagi¹,

Tadepalli²,

Reddy³

et al. 2021

Cureus

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In this report, we present a case of interventricular septal dissection (IVSD) following inferior wall myocardial infarction (MI) in a 64-year-old patient; the patient ultimately recovered after prompt resuscitation and intervention, despite the high mortality associated with these cases.A 64-year-old male with a history of hypertension and obesity was brought to the hospital following an episode of syncope at home. He had been experiencing chest tightness over the past few days prior to the admission. On physical exam, he had a heart rate of 72 beats per minute and blood pressure of 73/52 mmHg. His electrocardiogram revealed ST-segment elevations in leads II, III, and aVF. Emergent coronary angiography revealed 100% occlusion of the right coronary artery (RCA) with no collateral supply and 95% stenosis of the left anterior descending (LAD) artery. Aspiration thrombectomy and balloon angioplasty and subsequent stenting of the RCA were performed. Transthoracic echocardiogram with color Doppler was performed, which confirmed the presence of a defect in the septum. Color Doppler demonstrated a clear jet entering the ventricular septum from the left ventricle (LV), with the jet traversing the entire length of the septum through a dissection and entering into the right ventricle (RV), consistent with complete IVSD. The patient subsequently underwent a successful bovine pericardial patch repair of the ventricular septum.IVSD is a rare anomaly of the IVS. An echocardiogram is a useful tool to establish the diagnosis. The mortality rate after ventricular septal rupture remains high. Fortunately, our patient had interventricular dissection without rupture. Prompt surgical repair remains the choice of treatment for this condition.

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Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction

Cited by 5 publications

References 4 publications

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

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

Post-myocardial infarction left ventricular septal dissecting aneurysm: a case report

Complete Dissection of the Interventricular Septum Following Myocardial Infarction

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