Open AccessVentricular Septal Rupture after Acute Coronary Syndrome
Author(s) -
Pedro Rafael de Oliveira Nascimento,
Gustavo Góes,
Caroline Bernardi Fabro,
Mateus Lopes Barreto de Sousa,
Diana Patricia Lamprea Sepulveda,
Isly Maria Lucena de Barros,
José María Castillo,
José Breno de Sousa Filho,
Ricardo de Carvalho Lima,
Dário Celestino Sobral Filho
Publication year - 2019
Publication title -
international journal of innovative research in medical science
Language(s) - English
Resource type - Journals
ISSN - 2455-8737
DOI - 10.23958/ijirms/vol04-i10/741
Subject(s) - medicine , myocardial infarction , acute coronary syndrome , cardiology , complication , infarction , surgery
Objective: Ventricular septal rupture (VSR) is a rare but serious complication of acute myocardial infarction, which occurs in about 0.2 to 0.3% of patients with myocardial ischemia. If early therapy is not initiated, 90% of patients with VSR will die within the first month. This study aimed to evaluate the epidemiological and clinical characteristics of patients with VSR as a mechanical complication of acute myocardial infarction. Methods: A prospective study was conducted among nine patients who presented to the Cardiovascular Emergency Room of Pernambuco with acute coronary syndrome with ST segment elevation and VSR complications. Results: There were five women and 4 men, and the mean age of the patients was 72.5 years. The median time from the onset of the symptoms of acute coronary syndrome with ST segment elevation to the diagnosis of VSR was 3.5 days. Among the nine patients included in the study, three were treated surgically. Of all the patients, including those who underwent corrective surgery, eight patients died, 44.4% (N = 4), in the first four days after AMI. Conclusion: VSR occurs more frequently among elderly patients with multi-arterial involvement, lower wall infarction, and involvement of the right coronary artery. The prognosis is extremely limited, especially in patients who are already admitted to the cardiac emergency room with Killip IV, with > 24 hours of clinical evolution, and do not require surgical correction.