RESUMEN
Post myocardial ventricular septal rupture (VSR) is one of the most fatal complications of acute myocardial infarction (AMI) in spite of percutaneous and surgical closure. With the advancement of percutaneous coronary interventions in a timely manner, incidence of post MI VSR has declined remarkably. However, the COVID-19) pandemic-related late hospital presentations with AMI increases the possibilities of a potential upward shift in the incidence of post MI VSR. This case report aimed to increase awareness of negative contributions of the current pandemic to AMI and its fatal complications.
Asunto(s)
COVID-19 , Infarto del Miocardio , Rotura Septal Ventricular , COVID-19/complicaciones , Miedo , Humanos , Infarto del Miocardio/complicaciones , Choque Cardiogénico/complicaciones , Rotura Septal Ventricular/diagnóstico por imagen , Rotura Septal Ventricular/etiología , Rotura Septal Ventricular/cirugíaRESUMEN
Postinfarction ventricular septal rupture (VSR) represents a well-known mechanical complication of myocardial infarction, determining cardiogenic shock with high mortality rates. Surgical correction requires significant expertise to avoid cardiac rupture, uncontrollable bleeding, residual shunts, heart failure, and death. In the last year, we observed a substantial increase of VSR at our hospital, related to the delayed presentation of people with acute chest pain to the emergency departments during the coronavirus disease 2019 pandemic. We discuss our innovative triple-layer patch technique in a recent consecutive series of 8 patients. This technique proved effective in all patients, with no residual shunt or cardiac rupture.
Asunto(s)
COVID-19/epidemiología , Procedimientos Quirúrgicos Cardíacos/métodos , Prótesis e Implantes , Rotura Septal Ventricular/cirugía , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Pandemias , Factores de Riesgo , Rotura Septal Ventricular/diagnóstico , Rotura Septal Ventricular/epidemiologíaRESUMEN
During the coronavirus disease 2019 (COVID-19) pandmic, more patients are presenting with complications late after acute myocardial infarction. We report the case of a 71-year-old man who delayed seeking medical care for 2 weeks, despite progressive shortness of breath, cough, and tactile fever, for fear of contracting COVID-19 in the hospital. Clinical and echocardiographic evaluation revealed a ventricular septal rupture secondary to acute myocardial infarction. The patient underwent urgent cardiac catheterization, followed by successful saphenous vein grafting to the left anterior descending coronary artery and open surgical repair of the ventricular septal rupture with a bovine pericardial patch. This case highlights a potential long-lasting negative effect that the COVID-19 pandemic will have on the care-seeking behavior and health of patients with acute cardiovascular disease.
Asunto(s)
COVID-19 , Cateterismo Cardíaco/métodos , Puente de Arteria Coronaria/métodos , Miedo , Aceptación de la Atención de Salud/psicología , Infarto del Miocardio con Elevación del ST , Rotura Septal Ventricular , Anciano , COVID-19/epidemiología , COVID-19/psicología , Angiografía Coronaria/métodos , Ecocardiografía/métodos , Electrocardiografía/métodos , Humanos , Masculino , SARS-CoV-2 , Infarto del Miocardio con Elevación del ST/complicaciones , Infarto del Miocardio con Elevación del ST/diagnóstico , Infarto del Miocardio con Elevación del ST/fisiopatología , Infarto del Miocardio con Elevación del ST/cirugía , Tiempo de Tratamiento/tendencias , Resultado del Tratamiento , Rotura Septal Ventricular/diagnóstico , Rotura Septal Ventricular/etiología , Rotura Septal Ventricular/fisiopatología , Rotura Septal Ventricular/cirugíaRESUMEN
Amid the coronavirus disease 2019 (COVID-19) pandemic, there is an unprecedented increase in public avoidance of hospitals predominantly driven by fear of contracting the virus. Recent publications highlight a re-emergence of rare post-myocardial infarction complications. While mechanical complications are infrequent in the era of primary percutaneous coronary intervention, they are associated with high mortality rates. The concurrent occurrence of mechanical complications such as left ventricular aneurysm and ventricular septal rupture is an extremely rare entity. We hereby delineate a unique case of a 53-year-old Caucasian male who underwent successful concomitant closure of a ventricular septal rupture, left ventricular aneurysmectomy, and 3-vessel coronary artery bypass grafting. Due to a delayed initial presentation owing to the patient's fear of contracting COVID-19, the surgery was carried out 3 months after the myocardial infarction. His postoperative evaluation confirmed normal contractility of the left ventricle and complete closure of the ventricular septal rupture. Six months postoperatively, the patient continues to do well. We also present a literature review of the mechanical complications following delayed presentation of myocardial infarction amid the COVID-19 pandemic. This article illustrates that clinicians should remain cognizant of these extremely rare but potentially lethal collateral effects during the ongoing global public-health challenge. Furthermore, it highlights a significant concern regarding the delay in first medical contact due to the reluctance of patients to visit the hospital during the COVID-19 pandemic.