Murmur after myocardial infarction: Is always a post myocardial infarction ventricular Septal defect: Case report
ABS TRACT Symptoms of acute left heart failure dominate in both ventricular septal defects occurring after transmural myocardial infarctions (post MI VSD) and rupture of a sinus Valsalva aneurysm (SVA), which may pose a difficulty in differential diagnosis. Ruptured SVA mandate prompt and urgent surgical correction. Also patients with post myocardial infarction VSD should undergo emergent surgery. The success of the surgery in both situations depends on the prompt medical stabilization of the patient and the prevention of cardiogenic shock. Implantation of an intraaortic balloon pump would have been life-saving in case of a post-MI VSD, but would have increased the aorto-right atrial shunt and aggravate the left heart failure in a ruptured SVA, thus may have even led to the loss of the patient. Simultaneous coronary artery disease and ruptured SVA is extraordinarily rare. We present here, a case of ruptured SVA with concomitant coronary artery disease, who had an MI two weeks before. Copyright © 2013 by Türkiye Klinik leri.