Post-infarction ventricular septal defect
Chest pain, shortness of breath, nausea, diaphoresis and palpitations.
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This footage represents an abrupt interruption within the normal myocardium of the interventricular septum. Color Doppler shows flow between the left and the right ventricle.
Ultrasound images show a 7 mm Left/Right muscular VSD. Qp:Qs= 2.6
The left ventricle is mildly hypertrophied.
The left atrium is mildly dilated.
The right ventricular diameter and function are within normal.
4 case question available
The patient presented with acute anteroseptal STEMI.
After the initiation of intravenous thrombolytic therapy, patient was stabilized with normal vital signs. Auscultation: no heart murmurs, bi-basilar lung fine crackles.
Day 3 follow-up: no chest pain, orthopnea nor paroxysmal nocturnal dyspnea.
Auscultation revealed a hollow systolic murmur.
Ventricular septal defect (VSD) is a rare but life-threatening mechanical complication of acute myocardial infarction; patients should undergo emergency surgical or percutaneous intervention to prevent hemodynamic deterioration and multi-organ failure.
It may occur within 24 h to several days after myocardial infarction and the diagnosis is confirmed by echocardiography.
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- 2. Yu-Chen Wang and Ping-Han Lo TCTAP C-228 Successful Closure of Post-myocardial Infarction Ventricular Septal Defect with Transcatheter Occluder DOI: 10.1016/j.jacc.2014.02.506
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