Clinical Variability in Post-myocardial Infarction Ventricular Septal Defects With Similar Echocardiographic Characteristics: A Case Series

Abstract

A ventricular septal defect (VSD) is a rare but critical complication of acute myocardial infarction (AMI), occurring in up to 0.2% of patients undergoing a percutaneous coronary intervention (PCI). An inferior VSD is less common than anterior VSD but has a worse prognosis, often presenting with hypotension, dyspnea, and a new holosystolic murmur. Two patient cases are provided of post-AMI VSD, following right coronary artery (RCA) infarction, both initially treated with PCI. In both these patient cases, echocardiography identified a basal inferoseptal aneurysm, with an 8.0-mm defect and a shunt. Both patients were referred for surgical intervention based on these diagnostic findings. This low-level evidence highlights the variability and severity of post-AMI VSD, in these patients. Despite advancements in reperfusion therapy, vigilant monitoring for late complications and timely intervention can be crucial and may improve outcomes, for this life-threatening condition.