Author + information
- Received June 22, 2010
- Accepted June 29, 2010
- Published online February 15, 2011.
A 67-year-old male presented to the emergency room with 1 h of chest pain and was found to have ST-segment elevation in the inferior leads on electrocardiogram. Coronary angiography revealed occlusion of the right coronary artery. During left ventriculography, contrast dye was seen in the right ventricle (A, Online Video 1). A stat transesophageal echocardiogram was performed and showed rupture of the ventricular septum (B, Online Video 2). The patient was found also to have simultaneous rupture of the posterior medial papillary muscle (C, Online Video 3). Color Doppler showed severe mitral regurgitation and confirmed the left-to-right shunt across a ventricular septal defect (D, Online Video 4). Complex ventricular septal defects can be associated with tearing of the ventricular free wall or papillary muscle. The patient was emergently taken to the operating room for surgical repair. He was discharged 1 month later in stable condition.
- Received June 22, 2010.
- Accepted June 29, 2010.
- American College of Cardiology Foundation