Post-infarction ventricular septal defect: a devastating complication

Defecto septal ventricular postinfarto: complicación devastadora

Introduction: ventricular septal communication is the most frequent mechanical complication of acute myocardial infarction (MI), especially if associated with ST-segment elevation, featuring a rate of around 0.21%, which increases in older patients with extensive defects and no reperfusion therapy. In patients with multivessel involvement and no collateral circulation; it is a catastrophic situation which carries a poor prognosis. Case reports: two patients admitted to a university hospital in Bogotá, with ST-elevation post-MI VSD, undergoing no early reperfusion, both in cardiogenic shock. The first patient had a torpid evolution and early mortality. The second patient underwent a VSD transcatheter repair 10 days after MI, determining significant periprocedural increase in the size of the septal defect, with greater hemodynamic instability and death.

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