Abstract
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.
Muhammad Adil, Zohaib Ullah Zahid, Muhammad Saad Jibran, Shahzeb, Muhammad Irfan. (2018) POST MYOCARDIAL INFARCTIONVENTRICULAR SEPTAL RUPTURE ANDFACTORS ASSOCIATED WITH ITSMORTALITY: A RETROSPECTIVE STUDY, KHYBER MEDICAL UNIVERSITY JOURNAL, Volume 10, Issue 3.
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