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CES Medicina
versão impressa ISSN 0120-8705
Resumo
CACERES-ACOSTA, Manuel Felipe et al. Ventricular septal defect after acute myocardial infarction: an unusual but life-threatening complication. CES Med. [online]. 2021, vol.35, n.1, pp.51-59. Epub 27-Out-2021. ISSN 0120-8705. https://doi.org/10.21615/cesmedicina.35.1.6.
Introduction:
early coronary revascularization has reduced the occurrence of mechanical complications of acute myocardial infarction; ventricular septal defect (interventricular communication) usually occurs between the third and fifth days after the event. We present an unusual case where the predominant symptoms were mainly gastrointestinal.
Description:
A 65-year-old male patient with a history of high blood pressure, active smoking and frequent alcohol consumption, consulted for gastrointestinal symptoms and chest pain with atypical characteristics. In the physical examination a holosystolic murmur with predominance in the foci of the base was found, the electrocardiogram documented QS in the inferior wall without alterations of the ST-T segment, positive cardiac biomarkers and the echocardiogram reported systolic dysfunction, basal and middle segment aneurysm of the lower wall, with ventricular septal defect with left to right flow. A diagnostic coronary angiography was performed founding two vessel severe disease, then the patient was surgically intervened for ventricular aneurysm correction, ventricular septal defect and coronary bypass.
Conclusion:
Recognizing the atypical clinical manifestations of acute myocardial infarction and a well-performed physical examination make it possible to identify serious problems such as the mechanical complications of infarction.
Palavras-chave : Myocardial infarction; Ventricular septal defect; Heart aneurysm.