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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
a) loud holosystolic murmur along left sternal border
- murmur increases with handgrip
- murmur decreases with amyl nitrite
b) thrill is often felt in the same location
c) may be little blood flow through the defect
d) patient may be asymptomatic
- large defects
- mitral diastolic rumble at apex, especially when shunt is more than 2.5:1
General
rupture
complications of myocardial infarction
ventricular septal defect
References
- Medical Knowledge Self Assessment Program (MKSAP) 16, 18
American College of Physicians, Philadelphia 2012, 2018