Late Presentation of Acute Coronary Syndrome Complicated by Ventricular Septal Rupture

Acquired ventricular septal rupture (VSR) is a rare but potentially fatal complication of late-presenting myocardial infarction (MI). In the era of revascularization and reperfusion therapy, the incidence of VSR has significantly decreased. Ruptures occur predominantly in patients with late-presenti...

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Published inCurēus (Palo Alto, CA) Vol. 15; no. 8
Main Authors Sherlock, Daniel, Labchuk, Andrii, Hussain, Umar, Khan, Muhammad A, Wlodkowski, Piotr, Patel, Nishant
Format Journal Article
LanguageEnglish
Published Palo Alto Cureus Inc 13.08.2023
Cureus
Subjects
Acute coronary syndromes
Cardiac arrhythmia
Cardiac catheterization
Cardiology
Cardiovascular disease
Coronary vessels
Electrocardiography
Emergency medical care
Extracorporeal membrane oxygenation
Heart failure
Hemodynamics
Hospitals
Hypertension
Intubation
Ischemia
Mortality
Patients
Ultrasonic imaging
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Summary:Acquired ventricular septal rupture (VSR) is a rare but potentially fatal complication of late-presenting myocardial infarction (MI). In the era of revascularization and reperfusion therapy, the incidence of VSR has significantly decreased. Ruptures occur predominantly in patients with late-presenting ST elevation MI. Patients may present with a wide variety of symptoms ranging from chest pain and mild hemodynamic instability to profound cardiogenic shock. Inotropes, vasopressors, and mechanical support with intra-aortic balloon pumps and extracorporeal membrane oxygenation can be used to bridge patients to surgery. Despite treatment with ventricular septal repair, postsurgical mortality remains high. There is a wide variety of complications that can occur in the postoperative period. A multidisciplinary approach is vital in these patients who develop VSR. Improving awareness among healthcare professionals regarding the symptoms of acute coronary syndrome can hopefully help prevent delayed presentation of patients to healthcare facilities.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.43427