Acute ischaemic ventricular inferoseptal defect in a pyretic patient: a diagnostic challenge

A 78-year-old Caucasian male presented with a 5-day progressive history of fever, vomiting and dyspnoea. Initial clinical examination revealed fever, sinus tachycardia, hypotension, peripheral cyanosis and a systolic murmur. Investigations revealed a multiple organ dysfunction syndrome. A repeat tra...

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Published inBMJ case reports Vol. 2011; no. dec08 1; p. bcr0720114452
Main Authors Muscat, Martina, Laverse, Etienne, Haq, Zaka, Chahal, Anwar Ahmad, Akhtar, Javed
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 08.12.2011
BMJ Publishing Group
SeriesReminder of important clinical lesson
Subjects
Acute Disease
Aged
Aneurysms
Cardiac arrhythmia
Coronary vessels
Europe (West)
Fever - etiology
Heart Septal Defects, Ventricular - complications
Heart Septal Defects, Ventricular - diagnosis
Hemodynamics
Humans
Male
Mortality
Multiple organ dysfunction syndrome
Myocardial Ischemia - complications
Myocardial Ischemia - diagnosis
Reminder of Important Clinical Lesson
Sepsis
Ultrasonic imaging
Veins & arteries
White
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Summary:A 78-year-old Caucasian male presented with a 5-day progressive history of fever, vomiting and dyspnoea. Initial clinical examination revealed fever, sinus tachycardia, hypotension, peripheral cyanosis and a systolic murmur. Investigations revealed a multiple organ dysfunction syndrome. A repeat trans-thoracic echocardiogram showed a basal inferoseptum aneurysm associated with an acquired ventricular septal defect not demonstrated on initial scan. An intra-aortic balloon pump was urgently inserted and he underwent surgical repair of the defect, 7 days after his initial presentation. He unfortunately died from postoperative complications.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.07.2011.4452