postinfarction ventricular septal rupture
Mechanical complication of acute myocardial infarction involving rupture through the interventricular septum.
Full Definition
Postinfarction ventricular septal rupture is a catastrophic mechanical complication of acute myocardial infarction that occurs when necrotic myocardial tissue in the interventricular septum ruptures, creating an abnormal communication between the left and right ventricles. This complication typically occurs 3-7 days after myocardial infarction when the necrotic tissue is most vulnerable but before significant collagen deposition has occurred. The rupture site shows acute inflammatory infiltrates, hemorrhage, and coagulative necrosis extending through the full thickness of the septal wall. Anterior infarctions typically cause apical septal ruptures, while inferior infarctions cause more basal posterior septal defects. The condition requires immediate surgical repair due to the acute left-to-right shunt and associated cardiogenic shock.
Usage
Usage note: Distinguish from congenital ventricular septal defects by using 'postinfarction' or 'acquired' terminology.
In Context
- "The patient developed postinfarction ventricular septal rupture five days after anterior STEMI, requiring emergency surgical repair." — Clinical case report
- "Autopsy demonstrated postinfarction ventricular septal rupture with a 2.5 cm defect in the apical interventricular septum." — Autopsy report