Perforation of the interventricular septum complicating myocardial infarction

Summary Eight cases of ventricular septal perforations are presented, and the present literature, consisting of 132 cases, is reviewed. The diagnosis of this condition should be strongly considered when a patient with an acute myocardial infarction suddenly develops a blowing systolic murmur along the lower left sternal border. Recognition is of importance in a consideration of the prognosis, as less than 10 per cent survive one year. In one patient, cardiac catheterization was performed in an attempt to confirm the diagnosis, and in two patients the unusual combination of a ruptured septum and a ruptured ventricle was present. The differential diagnosis has been discussed, with particular attention to the differentiation of septal perforation from papillary muscle rupture.