Abstract
Background
Ventricular septal rupture (VSR) is a rare but life-threatening complication of ST-elevation
myocardial infarction. Point-of-care ultrasound (POCUS) is a rapid, noninvasive imaging
modality that is easily accessible and highly effective in diagnosing VSR in the emergency
department (ED) setting.
Case Report
A 73-year-old man with a history of type II diabetes mellitus and hypertension presented
with complaints of intermittent chest pain for 48 h that had since become constant,
associated with diaphoresis and shortness of breath. Physical examination was notable
for shock and a new, grade V/VI systolic murmur. An electrocardiogram showed evidence
of an inferior ST-elevation myocardial infarction (MI) with associated Q waves. POCUS
revealed a large ventricular septal rupture with new ventricular septal defect and
associated left-to-right shunting.
Why Should an Emergency Physician Be Aware of This?
POCUS in the ED setting is an effective and rapid tool for elucidating the etiology
of various shock states. Emergency physicians should be aware of this particular case,
as POCUS may help identify MI-related complications, including post-myocardial infarction
VSR, that may necessitate surgical intervention as opposed to coronary reperfusion
procedures.
Keywords
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References
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Article info
Publication history
Published online: September 14, 2022
Accepted:
September 4,
2022
Received in revised form:
August 16,
2022
Received:
May 16,
2022
Footnotes
E-Poster Presentation: American Institute of Ultrasound in Medicine (AIUM) Conference 2022. Presenter: Catherine Kirbos, MD; March 13, 2022; San Diego, California.
Streaming video: A brief real-time video clip that accompanies this article is available in streaming video at www.journals.elsevierhealth.com/periodicals/jem. Click on Video Clip 1.
Identification
Copyright
Published by Elsevier Inc.
