S. Premaratne et al., SURGICAL-MANAGEMENT OF VENTRICULAR SEPTAL RUPTURE FOLLOWING MYOCARDIAL-INFARCTION - THE HAWAII EXPERIENCE, Panminerva Medica, 38(2), 1996, pp. 78-83
Objective. To assess the diagnostic and treatment methods of ventricul
ar septal rupture following myocardial infarction in a small patient p
opulation, Experimental Design. Retrospective medical record review Se
tting, Four Honolulu area teaching hospitals, Patients or participants
. Eighteen patients with ventricular septal rupture (VSR) following my
ocardial infarction (MI) between 1979 and 1993, Results, Ventricular s
eptal rupture occurred more frequently in the elderly, in females and
in those presenting for the first time with an MI, Thirteen patients (
72%) underwent surgical repair including the two survivors, Three pati
ents (17%) also underwent coronary artery bypass grafting, one of who
survived, Very few of the patients had a history of stable angina pect
oris before MI. Sudden deterioration in the patient's condition as man
ifested by tachycardia, hypotension and signs of right heart failure i
n those with an acute MI, especially if accompanied by a systolic murm
ur should encourage a search for a mechanical cause, especially a VSR,
Conclusions. Two dimensional echocardiography or Swan-Ganz catheteriz
ation is 100% diagnostic and can be rapidly done at the bed side, Earl
y surgical repair is important to the overall prognosis.