• Isidoro Di Bella, Uberto Da Col, Enrico Ramoni, Alessandro Affronti, Alessia Rossi, and Temistocle Ragni.
• Department of Cardiac Surgery, S. Maria della Misericordia Hospital, Perugia, Italy. isidorodibella@yahoo.it
• J Cardiovasc Med (Hagerstown). 2010 Aug 1; 11 (8): 622-4.

AbstractIn rare cases of posterior myocardial infarction, septal rupture is the consequence of a dissecting interventricular hematoma that evolves as a fibrotic septal chamber with two separate communications, towards left and right ventricle. This unusual anatomical pattern is generally unsuspected and described as a normal interventricular defect associated with a basal left ventricular aneurysm or pseudoaneurysm. We present a case where echocardiography and ventricular angiography did not detect this situation. As surgical implications are important, this peculiar anatomical pattern should be suspected especially in patients with asymptomatic postinfarction posterior septal rupture or in those with minimal clinical impairment.

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