The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion

Figure 1

Signs and consequences of ventricular septal rupture due to acute myocardial infarction. (a) ECG. ST-segment elevation in leads II, III, aVF, and V6. (b) to (e): Computed tomography. (b) Transverse plane. Acute inferior myocardial infarction (black arrowheads) and ventricular septal rupture (black arrow), both associated with dilation of the right ventricle and retrograde flow of contrast agent into the liver veins due to acute right heart failure. (c) Sagittal plane. Ventricular septal rupture (black arrow) due to acute myocardial infarction with extensive microvascular obstruction (red arrowheads). (d) Transverse plane, arterial phase after intravenous injection of contrast agent. Contrast is seen in renal and hepatic veins as a sign of severe venous congestion. (e) Sagittal oblique plane, late phase after injection of contrast agent. Hepatic veins, hepatic parenchyma, and the portal vein (yellow arrow) are still opacified due to backward failure of the right heart.