Two Cases of Septal Perforation Following Acute Myocardial Infarction with Special Reference to Types of Infarction and a Study of Conduction System

Abstract

Two cases of septal perforation due to acute myocardial infarction were reported. The first case was typical and the second case was unusual, in which a perforation was produced by a small isolated septal infarction due to occlusion of a small branch of the right coronary artery (ramus ventriculi dextri posterior). The pathogenesis was discussed. The specific combination of conduction disturbance with right bundle branch block and left axis deviation in the second case was explained by connective tissue changes in the annulus fibrosus due probably to aging process.