Unveiling the Gravity: Ventricular Septal Rupture as Lethal Sequelae in Myocardial Infarction – A Case Series Analysis and Review of Literature

Abstract

In the prethrombolytic era, ventricular septal rupture (VSR) complicated 1%–3% of all acute myocardial infarctions (AMIs). However, since the introduction of reperfusion therapy, the incidence of VSR has decreased, complicating 0.17%–0.31% of AMIs. Despite a reduction in incidence, mortality of patients with VSR remains high (41%–80%). It is important to identify this rare, but lethal complication at the earliest, as it is associated with high morbidity and mortality. Even with early diagnosis, the survival rate is not good. The management of this fatal complication is also a topic of debate. Even after much research, the management of this fatal complication is not standardized. Here, we present a case series of nine patients who developed VSR as a postmyocardial infarction complication and discuss management options for this rare lethal complication. Cases: We present 9 cases of VSR as a postmyocardial infarction complication. Among these nine patients with VSR, three patients underwent surgical repair, whereas 6 were treated conservatively for various reasons. These cases illustrate the challenges confronted in the diagnosis and management of postmyocardial infarction VSR as one of the rare but lethal complications of myocardial infarction. VSR is a rare but fatal complication of myocardial infraction that poses a challenge in diagnosis and management due to its varying presentation. Therefore, increased awareness of key diagnostic features is crucial for the early recognition of this complication and its effective management.