When do ventricular septal ruptures occur in the setting of acute myocardial infarction (MI, heart attack), and which patients are at greatest risk for this complication?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Ventricular septal rupture (acute ventricular septal defect) is a rare but critical complication of MI. It occurs 2-8 days after an infarction and often precipitates cardiogenic shock. The differential diagnosis of postinfarction cardiogenic shock should exclude free ventricular wall rupture and rupture of the papillary muscles.

Ventricular rupture is more common in patients with anterior MI, individuals with hypertension, and those receiving nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids.


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