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Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID
The occurrence of post-myocardial infarction (MI) ventricular septal defect (VSD) is a rare but life-threatening complication. This case report presents a unique case of a 49-year-old female patient with an anterolateral ST-segment elevation MI who underwent percutaneous coronary intervention (PCI)...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404452/ https://www.ncbi.nlm.nih.gov/pubmed/37551229 http://dx.doi.org/10.7759/cureus.41525 |
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author | Riaz, Abdul Haseeb Younus, Usman |
author_facet | Riaz, Abdul Haseeb Younus, Usman |
author_sort | Riaz, Abdul Haseeb |
collection | PubMed |
description | The occurrence of post-myocardial infarction (MI) ventricular septal defect (VSD) is a rare but life-threatening complication. This case report presents a unique case of a 49-year-old female patient with an anterolateral ST-segment elevation MI who underwent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, complicated by a no-reflow phenomenon in the distal left anterior descending artery (LAD) and subsequent development of a hemodynamically significant VSD. Notably, this case occurred during the COVID-19 pandemic, which added to the complexity of the patient's management. The patient's clinical course was further complicated by cardiogenic shock, acute respiratory failure, COVID-19 pneumonia, and gastrointestinal bleeding. Despite these challenges, the patient received prompt treatment and optimal medical management, including the use of vasopressor support, insulin therapy, and bicarbonate infusions. The patient also underwent surgical repair of the VSD at a quaternary center, resulting in a favorable outcome. This case report highlights the increased incidence of mechanical complications, such as VSD, during the COVID-19 pandemic due to delayed presentation and patient concerns about exposure to the virus. It also emphasizes the occurrence of a no-reflow phenomenon during PCI, which can lead to adverse outcomes, including larger infarct size and potential ventricular septal rupture. The case further underscores the importance of multidisciplinary collaboration and early subspecialist involvement in managing complex cases of post-MI VSD. |
format | Online Article Text |
id | pubmed-10404452 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-104044522023-08-07 Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID Riaz, Abdul Haseeb Younus, Usman Cureus Cardiology The occurrence of post-myocardial infarction (MI) ventricular septal defect (VSD) is a rare but life-threatening complication. This case report presents a unique case of a 49-year-old female patient with an anterolateral ST-segment elevation MI who underwent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, complicated by a no-reflow phenomenon in the distal left anterior descending artery (LAD) and subsequent development of a hemodynamically significant VSD. Notably, this case occurred during the COVID-19 pandemic, which added to the complexity of the patient's management. The patient's clinical course was further complicated by cardiogenic shock, acute respiratory failure, COVID-19 pneumonia, and gastrointestinal bleeding. Despite these challenges, the patient received prompt treatment and optimal medical management, including the use of vasopressor support, insulin therapy, and bicarbonate infusions. The patient also underwent surgical repair of the VSD at a quaternary center, resulting in a favorable outcome. This case report highlights the increased incidence of mechanical complications, such as VSD, during the COVID-19 pandemic due to delayed presentation and patient concerns about exposure to the virus. It also emphasizes the occurrence of a no-reflow phenomenon during PCI, which can lead to adverse outcomes, including larger infarct size and potential ventricular septal rupture. The case further underscores the importance of multidisciplinary collaboration and early subspecialist involvement in managing complex cases of post-MI VSD. Cureus 2023-07-07 /pmc/articles/PMC10404452/ /pubmed/37551229 http://dx.doi.org/10.7759/cureus.41525 Text en Copyright © 2023, Riaz et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Riaz, Abdul Haseeb Younus, Usman Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title | Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title_full | Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title_fullStr | Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title_full_unstemmed | Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title_short | Post-myocardial Infarction Ventricular Septal Defect in the Setting of No-Reflow and COVID |
title_sort | post-myocardial infarction ventricular septal defect in the setting of no-reflow and covid |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404452/ https://www.ncbi.nlm.nih.gov/pubmed/37551229 http://dx.doi.org/10.7759/cureus.41525 |
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