Selective afterload reduction in the treatment of septal rupture complicating myocardial infarction. A case report.

Interventricular septal rupture complicating acute myocardial infarction is usually fatal unless corrective surgery can be delayed until adequate healing of the septum has occurred. A case is reported in which the degree of shunting through the ventricular septal defect was reduced by the use of hydralazine, a drug which selectively reduces peripheral vascular resistance. In spite of the fact that this patient eventually died before surgical repair could be carried out, the hydralazine did bring about a significant improvement in the left-to-right shunt ratio.