Ischemic Ventricular Septal Defect: Two Rare Cases

Introduction: Interventricular septal rupture occurring in the acute phase of a myocardial infarction is a rare complication, its incidence varies between 1 and 2%. We present the observation of two patients with myocardial infarction complicated by apical rupture of the interventricular septum.

Cases:

Case 1: We report a 56 years old female with a history of hypertension and diabetes mellitus admitted to our intensive care unit for a ST-Segment–Elevation Acute Coronary Syndrome treated with thrombolysis complicated with heart failure the patient presented a hemodynamic instability requiring the introduction of vasoactive drugs. We performed an echocardiography that showed a solution of continuity of the interventricular septum.

Case 2: We report a 88 years old active male smoker admitted to our intensive care unit for an anterior ST segment elevation acute coronary syndrome treated with thrombolysis. On the 2nd day of hospitalization, the patient presented a supra-ventricular tachycardia at 160bpm, an echocardiography was then realized which objectified a solution of continuity in the apical segment of the inter ventricular septum.

Conclusion: Ischemic ventricular defect is a rare, serious, and major mechanical complication of myocardial infarction. The best treatment is still surgery despite its high morbidity and mortality rate in the postoperative period.