Ventricular Septum Rupture After Myocardial Infarction Demonstrated by Multislice Computed Tomography

Abstract

Figure 1. Sixteen-row multislice computed tomography: interventricular communication.An 82-year-old female was admitted for syncope with previous history of chest pain. Physical examination revealed low blood pressure and an apical murmur. Echocardiogram: sinus rhythm and ST-segment elevation leads II, III and, aVF. Transthoracic echocardiogram was of poor technical quality because of obesity. Multislice computed tomography (MCT) was performed, which revealed a dilated right ventricle and apical ventricular septum rupture (Fig. 1). 1 Coronary angiography revealed severe left coronary atherosclerosis and occlusion of the right coronary artery. Shunt from the left to the right ventricle was confirmed by angiography (Fig. 2).Multislice computed tomography is a useful tool for patients with myocardial infarction and murmur. Figure 2. Left ventricle angiogram with contrast shunt to right ventricle (Big picture: right anterior oblique view. Small picture: left anterior oblique view).Reference 1. Zipes DP, Libby P, Bonow RO, Braunwald E: Braunwald's Hert Disease.

Early interventricular septum rupture after systemic thrombolysis in a patient with STEMI

“…La rottura del SIV è più frequente nelle donne, negli anziani, in corso di IMA anteriore e nei pazienti con malattia monovasale con un circolo collaterale poco sviluppato diretto al setto interventricolare ipertrofico [5]. In caso di IMA anteriore, la rottura è di solito localizzata nella parte anteroapicale del setto ipertrofico, mentre in caso di IMA inferiore il difetto si verifica nella parte basale del setto [6].…”