Ventricular Septal Rupture Complicating Acute Myocardial Infarction in a Tertiary Care Hospital of Nepal
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Abstract
Background: Ventricular septal rupture is a rare but fatal mechanical complication of acute myocardial infarction. Although the incidence has decreased, the mortality rate from ventricular septal rupture has remained extremely high.
Objectives: The aim of this study was to assess the patient with acute myocardial infarction complicating with ventricular septal rupture and to identify the risk factors for ventricular septal rupture in a tertiary level hospital of Nepal.
Patients and Methods: This is a retrospective analysis of 11 patients who were diagnosed as ventricular septal rupture complicating acute myocardial infarction in College of Medical Sciences & Teaching Hospital, Bharatpur, Nepal.
Results: All (100%) patients were female with mean age of 65.8±9.3 years. Three patients (27.3%) were smokers, seven (63.6%) were hypertensive, and four (36.4%) were diabetic. None of our patients had previous history of coronary artery disease. Nine (81.8%) patients had ventricular septal rupture in apical septum and two (18.2%) in basal septum. Since there was no backup cardiac surgery facility available in our hospital, all patients were managed conservatively. In-hospital mortality was 90.9%.
Conclusions: Ventricular septal rupture following acute myocardial infarction has very high in-hospital mortality and is more common in female patients with no previous history of coronary artery disease. Rupture in apical septum is more common than basal septum rupture.
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