A, A man in his 50s with an anterior ST-elevation myocardial infarction (STEMI) demonstrated typical appearance of an apical ventricular septal rupture on transthoracic echocardiography (TTE), with apical akinesis and left to right flow on TTE. B, Transesophageal echocardiogram (TEE) measured the defect at 9 mm. C, He underwent percutaneous closure of the defect, and TEE initially showed trivial residual shunt. D, Six days later, he developed worsening heart failure, and TTE showed increased mobility of the occlusion device with a large defect and significant left to right shunt. He proceeded to surgical patch closure of the defect. Click the Related Article link for a complete review of mechanical complications of acute myocardial infarction and the related video links to watch imaging findings of left ventricular septal rupture and papillary muscle rupture.
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