Selective Afterload Reduction in the Treatment of Septal Rupture Complicating Myocardial Infarction

Interventricular septal rupture complicating acute myocardial infarction is usually fatal unless corrective surgery can be delayed until adequate healing of the septum has occurred. A case is reported in which the degree of shunting through the ventricular septal defect was reduced by the use of hydralazine, a drug which selectively reduces peripheral vascular resistance. In spite of the fact that this patient eventually died before surgical repair could be carried out, the hydralazine did bring about a significant improvement in the left-to-right shunt ratio.