Thakkar Yachika, Thakkar Jay, Acharya Sourya, Shukla Samarth, Kamat Sandeep, Rao Tarun, Kumar Sunil
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Oct 2;14(10):e29848. doi: 10.7759/cureus.29848. eCollection 2022 Oct.
ST-segment elevation myocardial infarction (STEMI) is a known medical exigency that has seen considerable advances in medical treatment, dramatically boosting survival rates. Post myocardial infarction ventricular rupture is a major serious mechanical complication following myocardial infarction. We present a case of a 68-year-old male admitted to the emergency department with heaviness in the chest, for which electrocardiography was done and it was suggestive of anterior and lateral wall myocardial infarction. After six hours he experienced breathlessness, jugular venous pressure (JVP) was raised, and auscultation revealed early systolic murmur at apex suggestive of ventricular septal rupture. An urgent echocardiogram was done and it confirmed the diagnosis of ventricular septal rupture (VSR). To enhance the prognosis, early identification and appropriate care are required, which necessitate a thorough clinical evaluation that raises the possibility of mechanical problem, as late presentation is one of the major risk factors for developing VSR. VSR can manifest itself in numerous ways, based on the patient's condition. Right clinical judgement and ECG are required to establish a quick diagnosis, as a result, to determine the most appropriate treatment at the appropriate time.
ST段抬高型心肌梗死（STEMI）是一种已知的医疗急症，其治疗方法有了显著进展，大大提高了生存率。心肌梗死后心室破裂是心肌梗死后主要的严重机械性并发症。我们报告一例68岁男性因胸部沉重感入住急诊科，行心电图检查提示前壁和侧壁心肌梗死。6小时后，他出现呼吸困难，颈静脉压（JVP）升高，听诊在心尖部闻及收缩期早期杂音，提示室间隔破裂。紧急行超声心动图检查，确诊为室间隔破裂（VSR）。为改善预后，需要早期识别和恰当护理，这需要进行全面的临床评估以提高发现机械问题的可能性，因为延迟就诊是发生VSR的主要危险因素之一。根据患者情况，VSR可表现为多种形式。因此，需要正确的临床判断和心电图来快速确诊，以便在合适的时间确定最恰当的治疗方法。
