Septal rupture

The vast majority of ventricular septal defects (VSD) are congenital. Acquired VSDs are almost always a consequence of septal rupture following myocardial infarction, traumatic VSDs as a consequence of sharp or blunt chest trauma are exceptionally rare. Typically the post myocardial infarction ventricular septal defect (PMIVSD) occurs within the first week after the event (41). In the current era of thrombolysis about 0.2% of patients develop a VSD as a result of septal necrosis. Medical management of these patients is limited and carries a 30-day mortality of 94% compared with 47% who were treated surgically (42). 

Topaz O, Taylor AL, Interventricular septal rupture complicating acute myocardial infarction from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in current management. Am J Med 1992 93(6) 683-688. Review. 

Killen DA, PiehlerJM, BorkonAM, etal. Early repair of postinfarction ventricular septal rupture. Ann Thorac Surg 1997 63(1) 138-142. 

Toyoda Y, Shida T, Wakita N, Ozaki N, Takahashi R, Okada M. Evidence of apoptosis induced by myocardial ischemia A case of ventricular septal rupture following acute myocardial infarction. Cardiology 1998 90 149-151. 

Septal rupture usually occurs, in turn, in larger infarctions, especially due to a proximal LAD oc-... 

Most of patients with circumscribed cavernosal fibrosis or scar have had penile surgery or traumas. Postraumatic fibrosis usually results from healing of intracavernosal hematoma (Bertolotto and Pozzi Mucelli 2004 Munarriz et al. 2005) or rupture of the tunica albuginea from sudden bending of the erect penis. A recent report (Brant et al. 2007) describes a subset of patients with penile induration who were found to have only a circumscribed septal fibrotic change on penile ultrasonography. About 36% of these patients had a significant history of penile trauma. 

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