تلخیص
OBJECTIVES: To determine the incidence of ventricular septal rupture (VSR)
following acute myocardial infarction (AMI) and to find out factors associated
with its mortality.
METHODS: This retrospective study was done at Lady Reading Hospital,
Peshawar, Pakistan in which 03years (January-2014 to December-2016) data of
AMI patients was studied. Patients with VSR after AMI, diagnosed on
echocardiography were included. Chi-square test was applied to correlate
cardiovascular risk factors and clinical parameters with the mortality in post-MI
VSR patients.
RESULTS: A data of 6240 patients with AMI was analyzed in which 60 patients
had VSR (incidence rate of 0.96%) with 64.7% having acute anterior MI. It is 8.5
times greater in first-MI and have a delayed onset. Twenty-six patients were
excluded due to presence of concomitant complications and rest of 34 were
studied in detail. Mean age of post-MI VSR patients was 63.21±8.9years, among
them 52.9% were males. Mean time of development of VSR was 4.1±2.2days
with the minimum of 01day and maximum of 10days after diagnosis of AMI.
Nineteen patients (55.9%) didn't receive streptokinase. The mortality rate was
38.2% which was significantly associated with diabetes, tachycardia, shock, high
Killip class, renal impairment and multiple VSR's (P-value of 0.012, 0.021, 0.032,
0.031, 0.036 and 0.016 respectively).
CONCLUSIONS: VSR incidence after AMI in our study was 0.96% with 8.5
times greater in first-MI and have a delayed onset. Diabetes mellitus, multiple
lesions, presence of shock, tachycardia, renal impairment and high Killip class
after development of VSR are associated with high mortality.