Case Report
Volume: 4 | Issue: 10 | Published: Oct 28, 2020 | Pages: 332 - 335 | DOI: 10.24911/ejmcr/173-1571084941
A case of post-myocardial infarction ventricular septal rupture in an asymptomatic inferior STEMI
Authors: Matilde Conti , Enrico Rino Bregani , Mariairene Benedusi
Article Info
Authors
Matilde Conti
Scuola di Specializzazione in Medicina di Emergenza-Urgenza, Università degli Studi di Milano Bicocca, Milano, Italy
Enrico Rino Bregani
U.O.C. di Medicina Generale, Emostasi e Trombosi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
Mariairene Benedusi
Scuola di Specialzzazione in Medicina di Emergenza-Urgenza, Università degli studi di Milano, Milano, Italy
Publication History
Received: October 16, 2019
Revised: June 20, 2020
Accepted: June 24, 2020
Published: October 28, 2020
Abstract
Background: Post-ischemic ventricular rupture is a rare late complication of acute myocardial infarction and despite improvements in diagnosis, in medical and surgical treatment; it is still associated with a high mortality rate. Case Presentation: We present a case of septal rupture in a patient with an asymptomatic inferior STEMI, whose clinical examination was significant only for a systolic heart murmur. Diagnosis was made in the Emergency Department, about 6 hours from triage and about 1 hour from first medical evaluation. A multidisciplinary team managed the patient, who underwent an emercency PCI and reperfusion and then a late surgery at day 8 from diagnosis. Conclusion: Although it is a rare event, septal rupture is a life-threatening event and should be suspected in patients with myocardial infarction when a rapid hemodynamic deterioration, heart murmur, or right ventricle overload is observed. Bedside echocardiography allows early diagnosis and the management of the patient.
Keywords: Acute myocardial infarction, post-ischemic ventricular rupture, heart murmur, cardiothoracic surgery, emergency PCI, echocardiography, case report, green
