A Case Series of Ventricular Septal Rupture Post-myocardial Infarction in a Tertiary Hospital

A rare mechanical consequence that can occur after an acute myocardial infarction, particularly in the current thrombolytic era, is ventricular septal rupture. This condition exhibits a bimodal pattern of occurrence, with a higher frequency observed within the first 24 h and again between 3 and 5 days postinfarction. The risk of developing mechanical complications, such as ventricular septal rupture, is increased by delayed reperfusion of the artery affected by the infarction, which leads to tissue necrosis and death. Female gender, advanced age, raised Killip class, elevated cardiac biomarkers, delayed reperfusion, and ineffective thrombolysis are factors related to post-myocardial infarction ventricular septal rupture. While ventricular septal rupture is predominantly associated with ST elevation myocardial infarction, it has been infrequently documented in cases of acute non-ST segment elevation myocardial infarction (NSTEMI). The clinical presentation and progression of ventricular septal rupture are intricately related to the underlying pathophysiological mechanisms and the speed at which hemodynamic collapse and cardiogenic shock develop. Despite timely intervention, whether surgical or percutaneous, the prognosis remains grim, with a significant hospital mortality rate influenced by factors such as age, hemodynamic instability, and other pre-existing health conditions. The presentation, course, and results of five patients with ventricular septal rupture after myocardial infarction treated at our hospital during the previous two years are addressed in this case series.