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Article Details

Case Report

Volume 6, Issue 12 (December Issue)

A Perfect Storm: Navigating the Complexities of Post-myocardial Infarction Ventricular Septal Defect in Metabolic Syndrome

Hayatu Umar1*, Oboirien Omokhudu Isa2, Raghu Cherukupalli3, Nura Maiyadi Ibrahim4, Abdul Habu5, Adamu Mohammad1 and Abdulbasid Jabo Bashir1

1Department of Internal Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
2Department of Acute Medicine, Sheffield Teaching Hospital, Sheffield, United Kingdom
3Cardiovascular Division, Aster Prime Hospitals, Hyderabad, India
4Department of Cardiology, Mid YorkShire Teaching Hospitals NHS Trust, UK
5Department of Internal Medicine, Federal Medical Center Nguru, Yobe, Nigeria

*Corresponding author: Hayatu Umar, Department of Internal Medicine, Usmanu Danfodiyo University Teaching Hospital, 1, Garba Nadama Road, Sokoto, Nigeria. E-mail: drhiatoo@gmail.com

Received: December 27, 2024; Accepted: January 06, 2025; Published: January 15, 2025

Citation: Umar H, Omokhudu Isa O, Cherukupalli R, et al. A Perfect Storm: Navigating the Complexities of Post-myocardial Infarction Ventricular Septal Defect in Metabolic Syndrome. Clin Image Case Rep J. 2025; 6(12): 535.

A Perfect Storm: Navigating the Complexities of Post-myocardial Infarction Ventricular Septal Defect in Metabolic Syndrome
Abstract

The co-occurrence of rare and Lethal complications of myocardial infarction (MI) in metabolic syndrome (MetS). A 70-year-old man with hypertension and diabetes presented to our emergency department with a 3-day history of sudden onset of severe chest pain that is associated with diaphoresis, shortness of breath, feeling of impending doom, nausea, and unrecordable blood sugar on admission.

Meticulous physical examinations revealed pansystolic murmur loudest at left sternal edge, loud pulmonary component of second heart sound (P2), bi-basal coarse crepitation. While focus investigations revealed unrecordable random blood sugar (RBS), electrocardiography (ECG) significant ST segment elevation in leads II, III and aVF, elevated cardiac markers and NT pro BNP, echocardiography established ventricular septal defect, and derange urea, electrolyte and creatinine. A definitive diagnosis of inferior wall ST-elevation myocardial infarction (STEMI) complicated by acute heart failure (HF), ventricular septal defect (VSD), cardiogenic shock (CS), and cardiorenal syndrome (CRS) with co-occurring hyperosmolar hyperglycemic state (HHS) in MetS was established. He was stabilized with appropriated medical therapy and referred to heart surgery capable hospital.

This case underscores the potential for severe, life-threatening complications of myocardial infarction in metabolic syndrome particularly in resource constrained settings. Early recognition and timely referral to cardiac surgery capable centre are crucial for improving outcomes in such cases, especially in resource-limited settings.

Keywords: Post infarction ventricular septal defect; Heart failure; Cardiogenic shock; Cardiorenal syndrome; Metabolic syndrome