ventricular septal rupture

Etiology

• complication of myocardial infarction

Pathology

• size determines the degree of left to right shunt
• may cause pulmonary hypertension

Clinical manifestations

• usually occurs several days after myocardial infarction
• small defects
  • loud holosystolic murmur along left sternal border
    • murmur increases with handgrip
    • murmur decreases with amyl nitrite
  • thrill is often felt in the same location
  • may be little blood flow through the defect
  • patient may be asymptomatic
• large defects
  • mitral diastolic rumble at apex, especially when shunt is more than 2.5:1

More general terms

• rupture
• complications of myocardial infarction
• ventricular septal defect