Postinfarction Ventricular Septal Rupture

Anterior myocardial infarction is typically associated with apical VSDs whilst inferior myocardial infarctions are more commonly associated with basal VSD or posterior papillary muscle rupture. After confirmation of diagnosis by echocardiography or right heart catheter, which reveals a step up in oxygenation at ventricular level, urgent referral to a surgical centre is required, the outlook without surgical repair being extremely poor.

Anterior myocardial infarction associated with apical VSD carries a better surgical outlook than inferior myocardial infarction associated with basal VSD.

Reference

• Moore CA, Nygard TW, Kaiser DS et al. Postinfarction ventricular septal rupture: the importance of location of infarction and right ventricular function determining survival. Circulation 1986;74:45.