Ventricular septal rupture with right ventricular wall dissection after inferior ventricular infarction: A case report and literature review

J Clin Ultrasound. 2019 May;47(4):247-252. doi: 10.1002/jcu.22684. Epub 2019 Jan 4.

Abstract

Right ventricular (RV) wall dissection following ventricular septal rupture related to inferior myocardial infarction (MI) is an extremely rare complication with a high mortality rate. We report the case of a 61-year-old man who was admitted to our hospital because of syncope and intermittent chest pain with a precordial murmur. Transthoracic echocardiography showed a rupture at the basal infero-posterior septum and RV free-wall dissection forming an echolucent cavity that extended beyond the septum and subsequently re-entered into RV chamber. The patient's overall cardiac and renal functions deteriorated and he died 24 days after the diagnosis. We present a literature review of the published cases of complex dissecting tracts through the septum and RV wall in ischemic context.

Keywords: dissection; myocardial infarction; right ventricle; transthoracic echocardiography.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Echocardiography / methods*
  • Fatal Outcome
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Inferior Wall Myocardial Infarction / complications*
  • Inferior Wall Myocardial Infarction / diagnostic imaging*
  • Inferior Wall Myocardial Infarction / therapy
  • Intra-Aortic Balloon Pumping
  • Male
  • Middle Aged
  • Ventricular Septal Rupture / diagnostic imaging*
  • Ventricular Septal Rupture / etiology*
  • Ventricular Septal Rupture / therapy