Left Ventricular Angiography and Echocardiography Demonstrating Ventricular Septal Rupture

Video supplement to “Acute Dyspnea After Inferior-Wall Myocardial Infarction” by Ahmed et al. (October 2021 Clinical Images).

A 57-year-old woman presented with acute-onset dyspea with a duration of more than 2 days. Four days earlier, she had been thrombolyzed with streptokinase for inferior wall myocardial infarction in a nearby hospital. On examination, we found that the patient had elevated jugular venous pressure and systolic murmur in left lower parasternal region. In addition, there was a ventricular septal rupture in the posterobasal interventricular septum, with at least 2 exit points into the right ventricle, which is demonstrated in the following imaging series. Timely identification of ventricular septal rupture before PCI is of paramount importance, as it has major implications in management of the patient.

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