Myocardial Infarction with Ventricular Septal Rupture and Cardiogenic Shock (original) (raw)
2015, Baylor University Medical Center Proceedings
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This case report presents a 72-year-old woman who experienced acute anterior myocardial infarction, complicated by cardiogenic shock and ultimately ventricular septal rupture. Despite interventions including intra-aortic balloon counterpulsation and coronary catheterization, the patient did not recover and passed away shortly after admission. The report discusses the incidence, prognosis, and implications of ventricular septal rupture post-myocardial infarction, highlighting the importance of timely intervention for improved survival.
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POLSKIE ARCHIWUM MEDYCYNY WEWNĘTRZNEJ 2015; 125 (5) 386 the LV apex. An intraaortic balloon pump was immediately inserted. 2,3 A cardiac surgeon decided to postpone the closure of the ventricular septal rupture (VSR) because of a high risk of recurrent septal defect. Percutaneous closure with an Amplatzer septal occluder was also postponed for the same reason. On the fourth day of hospitalization, a sudden hemodynamic deterioration occurred, with a decrease in blood pressure to 70/50 mmHg, dyspnea, dizziness, and oliguria, considered to be signs of cardiogenic shock. Echocardiography 1 showed enlargement of apical septal dropout to 13 mm and a decrease of transseptal pressure gradient to 47 mmHg with deterioration of tricuspid regurgitation (gap in leaflet coaptation, 10 mm; decrease of the maximum RV-RA gradient to 26 mmHg). Emergency surgical closure of VSR and cut of the myocardial bridge were performed. The patient's condition continued to deteriorate despite surgery and intensive pharmacological treatment including high doses of inotropes and prolonged mechanical ventilation. On day 7 after the surgery, the patient died of refractory multiorgan failure.
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