Author/Authors :
Vakili-Zarch, Anoushiravan tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Hashemi, Mohammad Jafar tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Hashemi, Arash tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Shahrzad, Shahab tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Alizadehasl, Azin tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Hashemi, Ashkan tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران , Sabet, Ali Hossein tehran university of medical sciences tums - Rajaie Cardiovascular, Medical and Research Center, تهران, ايران
Abstract :
A 45-year-old man was referred to our hospital for angina pectoris 2 days after an anterolateral myocardial infarction. On admission, he had a blood pressure of 100/70 mm Hg and holosystolic murmur at the left sternal border. Transthoracic echocardiography showed akinesia in the apicoseptal, apicoinferior, and apicoposterior regions of the left ventricle, with large apical aneurysm and clot. There was also a large apical ventricular septal defect (VSD) with a significant left-to-right shunt. During cardiac catheterization, the only abnormality found beside the VSD was myocardial bridging in the mid part of the left anterior descending coronary artery and ostial lesion in the first diagonal artery. The patient was scheduled for bypass surgery and VSD closure
