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CASE REPORT
Delayed ventricular septal rupture complicating anterior wall myocardial infarction
  1. Rajdip Dulai,
  2. Aye Hline,
  3. Mahvesh Rana Javaid,
  4. Javed Akhtar
  1. Department of Cardiology, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, Essex, UK
  1. Correspondence to Dr Rajdip Dulai, rajdip.dulai{at}bhrhospitals.nhs.uk

Summary

A 59-year-old woman was admitted to our hospital with acute pulmonary oedema and cardiogenic shock 35 days after anterior ST elevation myocardial infarction. She developed a new loud pan systolic murmur. Echocardiography revealed a ventricular septal rupture with a significant left to right shunt. She was immediately transferred to the local cardiothoracic unit where she underwent a successful ventricular septal defect (VSD) repair. Ventricular septal rupture often presents within the first 24 hours of acute myocardial infarction and is rare thereafter. It carries a poor mortality (41–80%) even when recognised. Timely recognition of this life-threatening complication can help reduce the resultant morbidity and mortality. Doctors should be aware that this well-recognised complication may present unusually late as in this case.

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Footnotes

  • Contributors All authors were directly involved in the care of the patient. RD, AH and MRJ drafted the manuscript. JA supervised the writing of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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