FREQUENCY OF VENTRICULAR SEPTAL RUPTURE AS A COMPLICATION OF ACUTE ST-ELEVATION MYOCARDIAL INFARCTION IN PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL
Keywords:Acute Myocardial Infarction, ST elevation MI, Ventricular Septal Rupture
AbstractBackground: Nearly one-third of the world's population dies from cardiovascular disorders, the majority of which are caused by stroke and coronary artery problems and 80 percent of these fatalities occur in impoverished countries. This study was conducted to determine the frequency of ventricular septal rupture in patients with acute ST-elevation myocardial infarction presenting to cardiology unit Hayatabad Medical Complex Peshawar. Methods: This was descriptive cross sectional research study at the Department of Cardiology, MTI-Hayatabad Medical Complex, Peshawar, from January to July 2020. Detailed history was obtained including duration of symptoms, co-morbidities present and occupation. A thorough clinical examination was done for signs of heart failure and ventricular septal rupture. Patients’ demographics, clinical and laboratory parameters were recorded on a pro forma. All the data was analyzed statistically by using SPSS version 24.0. Results: A total of 179 patients were included in our study. Ventricular Septal Rupture (VSR), was recorded in 7 (3.9%) patients having Acute ST elevation of MI. In our study age, obesity, reperfusion therapy, location of MI and history of previous shock were observed to be non-significantly (p˂0.05) associated with high incidence of Ventricular Septal Rupture in patients having Acute ST elevation of MI. Conclusion: According to our findings, individuals with PI-VSR have a significant risk of acute-phase death. Furthermore, a significant incidence of acute-phase fatalities has been related to female gender and severe cardiac failure upon admission.
Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med 2016;4(13):256.
Goldsweig AM, Wang Y, Forrest JK, Cleman MW, Minges KE, Mangi AA, et al. Ventricular septal rupture complicating acute myocardial infarction: Incidence, treatment, and outcomes among medicare beneficiaries 1999–2014. Catheter Cardiovasc Interv 2018;92(6):1104–15.
Liebelt JJ, Yang Y, DeRose JJ, Taub CC. Ventricular septal rupture complicating acute myocardial infarction in the modern era with mechanical circulatory support: a single center observational study. Am J Cardiovasc Dis 2016;6(1):10–6.
Jones BM, Kapadia SR, Smedira NG, Robich M, Tuzcu EM, Menon V, et al. Ventricular septal rupture complicating acute myocardial infarction: a contemporary review. Eur Heart J 2014;35(31):2060–8.
Novak M, Hlinomaz O, Groch L, Rezek M, Semenka J, Sikora J, et al. Ventricular septal rupture–a critical condition as a complication of acute myocardial infarction. J Crit Care Med (Targu Mures) 2015;1(4):162–6.
Adil M, Zahid ZU, Jibran MS, Irfan M. Post myocardial infarction ventricular septal rupture and factors associated with its mortality: a retrospective study. Khyber Med Univ J 2018;10(3):154–8.
Riaz A, Kaleem M, Mughal S. Frequency of Complications of Anterior Wall Myocardial Infarction. Pak Heart J 2017;50(3):190–3.
Crenshaw BS, Granger CB, Birnbaum Y, Pieper KS, Morris DC, Kleiman NS, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation 2000;101(1):27–32.
Arnaoutakis GJ, Zhao Y, George TJ, Sciortino CM, McCarthy PM, Conte JV. Surgical repair of ventricular septal defect after myocardial infarction: outcomes from the Society of Thoracic Surgeons National Database. Ann Thorac Surg 2012;94(2):436–44.
Hirata N, Sakai K, Sakaki S, Ohtani M, Nakano S, Matsuda H. Assessment of perioperative predictive factors influencing survival in patients with postinfarction ventricular septal perforation. Classified by the site of myocardial infarction. J Cardiovasc Surg (Torino) 2000;41(4):547–52.
Mantovani V, Mariscalco G, Leva C, Blanzola C, Sala A. Surgical repair of post-infarction ventricular septal defect: 19 years of experience. Int J Cardiol 2006;108(2):202–6.
Coskun KO, Coskun ST, Popov AF, Hinz J, Schmitto JD, Bockhorst K, et al. Experiences with surgical treatment of ventricle septal defect as a post infarction complication. J Cardiothorac Surg 2009;4(1):1–5.
Topaz O, Taylor AL. Interventricular septal rupture complicating acute myocardial infarction: from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in current management. Am J Med 2005;93(6):683–8.
Pohjola-Sintonen S, Muller JE, Stone PH, Willich SN, Antman EM, Davis VG, et al. Ventricular septal and free wall rupture complicating acute myocardial infarction: experience in the Multicenter Investigation of Limitation of Infarct Size. Am Heart J 2005;117(4):809–18.
Birnbaum Y, Fishbein MC, Blanche C, Siegel RJ. Ventricular septal rupture after acute myocardial infarction. N Engl J Med 2002;347(18):1426–32.
Poulsen SH, Præstholm M, Munk K, Wierup P, Egeblad H, Nielsen-Kudsk JE. Ventricular septal rupture complicating acute myocardial infarction: clinical characteristics and contemporary outcome. Ann Thorac Surg 2008;85(5):1591–6.
Yip HK, Fang CY, Tsai KT, Chang HW, Yeh KH, Fu M, et al. The potential impact of primary percutaneous coronary intervention on ventricular septal rupture complicating acute myocardial infarction. Chest 2004;125(5):1622–8.
Figueras J, Alcalde O, Barrabés JA, Serra V, Alguersuari J, Cortadellas J, et al. Changes in hospital mortality rates in 425 patients with acute ST-elevation myocardial infarction and cardiac rupture over a 30-year period. Circulation 2008;118(25):2783–9.
Menon V, Webb JG, Hillis LD, Sleeper LA, Abboud R, Dzavik V, et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the SHOCK Trial Registry. J Am Coll Cardiol 2000;36(3S1):1110–6.
Prêtre R, Rickli H, Ye Q, Benedikt P, Turina MI. Frequency of collateral blood flow in the infarct-related coronary artery in rupture of the ventricular septum after acute myocardial infarction. Am J Cardiol 2000;85(4):497–9.
Skehan J, Carey C, Norrell M, De Belder M, Balcon R, Mills P. Patterns of coronary artery disease in post-infarction ventricular septal rupture. Heart 2005;62(4):268–72.
Moreyra AE, Huang MS, Wilson AC, Deng Y, Cosgrove NM, Kostis JB, et al. Trends in incidence and mortality rates of ventricular septal rupture during acute myocardial infarction. Am J Cardiol 2010;106(8):1095–100.
Huang SM, Huang SC, Wang CH, Wu IH, Chi NH, Yu HY, et al. Risk factors and outcome analysis after surgical management of ventricular septal rupture complicating acute myocardial infarction: A retrospective analysis. J Cardiothorac Surg 2015;10(1):1–10.
Members ATF, Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 2012;33(20):2569–619.
Pellanda L, Portal V, Maciel P, Furquim A, Schaan B. Transdiciplinary approach to the follow-up of patients after myocardial infarction. Clinics 2008;63:489–96.
Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;64(24):e139–228.
Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Kardiologia Pol Pol Heart J 2015;73(12):1207–94.