Therapeutic Considerations of Post-Myocardial Infarction Ventricular Septal Defect in the Elderly - An Educational Presentation.

Post-myocardial infarction ventricular septal defect is an infrequent complication associated with low survival rates in the absence of surgical management. An 80-year-old woman presents to the emergency department with an inferior wall ST-segment elevation myocardial infarction with complete occlusion of the right coronary artery and a rupture of the interventricular septum with rapid deterioration to cardiogenic shock. Advanced age, female sex, and cardiogenic shock are associated with high mortality. The use of intra-aortic balloon pump improves hemodynamic status, allowing stabilization in the preoperative period.