Publish in this journal
Journal Information
NOTICE Undefined index: paginaFinal (librerias/utilidadesHtml-cardio.php[88])
Vol. 55. Issue 1.
Pages 67- (January 2002)
Share
Share
Download PDF
More article options
NOTICE Undefined index: paginaFinal (librerias/utilidadesHtml-cardio.php[88])
Vol. 55. Issue 1.
Pages 67- (January 2002)
Full text access
Apical Postinfarction Ventricular Septal Defect and Anomalous Origin of Left Coronary Artery
Comunicación interventricular apical postinfarto inferior y origen anómalo de coronaria izquierda
Visits
5820
Salvatore Di Stefanoa, Joaquín J Alonsoa, Santiago Flóreza
a Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
This item has received
5820
Visits
Article information
Full Text

The patient was a 63-year-old woman with a history of high blood pressure, obesity, and stable effort angina. She was admitted for uncomplicated acute inferior myocardial infarction. On day 3, clinical signs of progressive heart failure appeared, with a harsh pansystolic murmur in the mitral focus irradiated to the right sternal edge. She developed cardiogenic shock and required inotropic medication and intra-aortic balloon counterpulsation. Transesophageal echocardiography disclosed left ventricular (LV) inferior akinesia, right ventricular (RV) dilation with severely impaired systolic function, and a large ventricular septal defect (VSD) in the apical septum. Left ventriculography (left oblique anterior view) confirmed the existence of an apical VSD and its dimensions (Figure 1). Coronariography and aortography ( Figures 2 and 3) detected the anomalous origin of the left coronary artery trunk (LCT) on the proximal segment of the right coronary artery (RC). The anterior descending (AD) and circumflex (CX) coronary arteries were poorly developed. The AD, posterior interventricular (PIV), and posterolateral coronary arteries were stenotic. The patient underwent emergency surgery to close the VSD with a Teflon patch and coronary bypass with the internal mammary artery to the first diagonal. The postoperative evolution was satisfactory and at 5 months she was asymptomatic.

Fig. 1.

Fig. 2.

Fig. 3.

The association of an apical VSD and inferior infarction is uncommon. In this patient, this association was due to the poor development of the anomalous left coronary artery, with a small anterior descending coronary artery and septal branches. As a result, the septal vessels dependent on the PIV irrigated the septum.

Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.