Late presentation of acute coronary syndrome complicated by ventricular septal rupture

Authors

Daniel Sherlock, Advocate Aurora HealthFollow
Andrii Labchuk, Advocate Aurora HealthFollow
Umar Hussain, Advocate Aurora HealthFollow
Muhammad A. Khan, Advocate Aurora HealthFollow
Piotr Wlodkowski, Advocate Aurora HealthFollow
Nishant Patel, Advocate Aurora HealthFollow

Recommended Citation

Sherlock D, Labchuk A, Hussain U, Khan MA, Wlodkowski P, Patel N. Late Presentation of Acute Coronary Syndrome Complicated by Ventricular Septal Rupture. Cureus. 2023;15(8):e43427. Published 2023 Aug 13. doi:10.7759/cureus.43427

Affiliations

Advocate Lutheran General Hospital

Abstract

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.

Type

Article

PubMed ID

37706137