Highlights the unusual late occurrence of mechanical complications (VSD and LV aneurysm) five weeks post-AMI in the thrombolytic era, emphasizing the need for prompt surgical intervention.
Successful late post-MI VSD repair with aneurysmectomy; hypothesis-generating for delayed mechanical complications in the thrombolytic era.
Mechanical complications of acute myocardial infarction (AMI) such as a ventricular septal defect (VSD) usually occur within the first week. In the thrombolytic era, the incidence of a VSD has not increased, but has been reported to occur earlier than previously described. We report an unusual case of an elderly Caucasian female with an acute anterior wall myocardial infarction treated with thrombolytic therapy. Her AMI was complicated by pulmonary edema secondary to a VSD and a left ventricular aneurysm five weeks later. Prompt diagnosis, immediate surgical closure of the VSD, and aneurysmectomy resulted in her complete recovery.
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Rachko et al. (2000) studied this question.
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