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

• Published in: BMJ Case Reports Vol. 2011
• Main Authors: Muscat, Martina, Laverse, Etienne, Haq, Zaka, Chahal, Anwar Ahmad, Akhtar, Javed
• Format: Report
• Language: English
• Published: BMJ Publishing Group Ltd 2011
• ISSN: 1757-790X
• DOI: 10.1136/bcr.07.2011.4452

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.