Rotura del septum ventricular como complicación del infarto agudo de miocardio con elevación del segmento ST: reporte de un caso

Abstract

Ventricular septal rupture as a mechanical complication after acute myocardial infarction (AMI) is rare after the use of fibrinolytic drugs, but highly fatal. It should be suspected in patients with dyspnea, chest pain, pansystolic murmur in the left sternal border and cardiogenic shock, confirming the defect, location and size through echocardiography and color Doppler. Surgical management remains the best therapeutic option compared to medical management. We present a case report of an elderly male patient with arterial hypertension who developed an anterolateral ST segment elevation myocardial infarction. Fibrinolysis with alteplase was performed and subsequently coronary angiography plus rescue percutaneous coronary intervention in the first 24 hours in the anterior descending artery. On the fourth day after the onset of the clinical picture, ventricular septal rupture was documented, leading to cardiogenic shock and subsequent death.