Ischämische Septumruptur – die Differenzialdiagnose zum Re-Infarkt: ein Anwendungsbeispiel für den präklinischen Ultraschall

Zusammenfassung

Die ischämische Septumruptur ist eine seltene, jedoch gefürchtete Komplikation nach einem Myokardinfarkt. Die folgende Kasuistik demonstriert eine solche Erkrankung als Differenzialdiagnose zum myokardialen Re-Infarkt. Bei verdächtiger Symptomatik konnte schließlich die richtige Diagnose mittels Ultraschall gestellt und eine adäquate Zielklinik ausgewählt werden. Innerklinisch wurde der Defekt mit einem bovinem Perikardpatch versorgt. Nach einem stationären Aufenthalt von 19 Tagen konnte die Patientin ohne größere Residuen nach Hause entlassen werden.

Abstract

Ventricular septum rupture is a rare, but severe complication after myocardial infarction. This case report discusses it as a differential diagnosis of myocardial reinfarction. Point of care ultrasound performed on a patient presenting with suspicious symptoms during transport in the emergency ambulance confirmed the diagnosis prior to hospitalisation. Respectively, the patient was transferred to a specialized hospital. Cardiac surgery was performed to fix the rupture using a bovine pericardial patch. After 19 days of in-patient stay the patient was discharged with only minimal residual damage.

Schlüsselwörter

Ventrikelseptumruptur - Myokardinfarkt - Re-Infarkt - Ultraschall - Point of Care - Präklinik

Keywords

ventricular septum rupture - myocardial infarction - prehospital emergency medicine - ultrasound - point of care - POCUS

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