Key result
Delayed inferior STEMI presentation triggers fatal dual ventricular rupture and rapid cardiogenic shock.
Why the study?
Post-infarction mechanical complications such as ventricular septal rupture and right ventricular free-wall rupture are rare but fatal, making early recognition critical.
Case Report (n=1)
No
Simultaneous ventricular septal rupture and right ventricular free-wall rupture is an exceptionally rare and rapidly fatal mechanical complication of delayed myocardial infarction.
Fatal dual rupture in delayed STEMI warrants imaging vigilance in shock; case report leaves open prevention strategies in elderly patients.
Post-infarction mechanical complications, including ventricular septal rupture and right ventricular free-wall rupture, are rare but fatal. Early recognition is critical to improve outcomes. A 95-year-old man with pulmonary fibrosis experienced chest pain three days before hospitalization. On admission, he had inferior STEMI with second-degree atrioventricular block, outside the reperfusion window. The next day, he developed recurrent chest pain and hemodynamic shock. Transthoracic echocardiography revealed a muscular inferno-septal ventricular septal rupture (VSR) combined with right ventricular free-wall rupture (RVFWR). The coexistence of VSR and RVFWR is exceedingly rare and carries high mortality, highlighting the importance of early multimodality imaging and prompt diagnosis.
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Cherkaoui et al. (2026) conducted a case report in Acute myocardial infarction with mechanical complications (n=1). Delayed presentation of inferior STEMI was evaluated on Mortality. A 95-year-old man with delayed presentation of inferior STEMI developed simultaneous ventricular septal rupture and right ventricular free-wall rupture, resulting in rapid fatal cardiogenic shock.
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