Delayed treatment of acute inferior and right ventricular myocardial infarction resulting in interventricular septal dissection with multiple perforations after percutaneous coronary intervention: a case description

Abstract

tissue. Reestablishing coronary blood flow, or reperfusion, is essential; however, paradoxically, it may also lead to increased irreversible myocardial injury and cellular necrosis (4). Due to the very limited regenerative capacity of the heart, injured myocardial cells cannot be effectively replaced. Patients may thereafter experience heart failure, arrhythmias, diminished cardiac function, or sudden cardiac death (5). Some patients with myocardial infarction may initially present only with referred upper abdominal pain, without the typical clinical presentation of retrosternal chest pain. In gastroenterology, this symptom may be mistaken for acute gastrointestinal disorders, potentially leading to misdiagnoses and delayed detection and treatment of coronary artery disease. This article describes the case of a patient with myocardial infarction who initially only experienced upper abdominal pain before seeking medical attention. During coronary balloon dilation and revascularization, the patient developed multiple perforations and a fresh ventricular septal tear.