case_images: PMC4763561_01
case_images: EKG showing sinus tachycardia with q waves and ST segment elevations of almost 2 mm in leads III and aVF (arrow) along with ST segment depressions in I and aVL leads. This implies that there is possible inferior wall infarction. Left atrial enlargement also noted.
case_images: JCHIMP-6-30460-g001.jpg
case_images: PMC4763561_01_JCHIMP-6-30460-g001.jpg
case_images: F0001
case_images: There was also left atrial enlargement (Fig. 1).
case_images: Echocardiogram with color Doppler displaying a ventricular septal defect postmyocardial infarction (arrow).
case_images: JCHIMP-6-30460-g002.jpg
case_images: PMC4763561_01_JCHIMP-6-30460-g002.jpg
case_images: F0002
case_images: At the tertiary care hospital, transesophageal echocardiogram (TEE) was done, which revealed large VSD with a dimension of 1.38x0.9 cm2 and an area of 0.9 cm2 located in the posterior wall of ventricle (Fig. 2).
case_images: Transesophageal echocardiogram showing ventricular septal defect (arrow) with size.
case_images: JCHIMP-6-30460-g003.jpg
case_images: PMC4763561_01_JCHIMP-6-30460-g003.jpg
case_images: F0003
case_images: TEE also showed mildly reduced RV systolic function and moderate to severe tricuspid regurgitation (Figs. 3 and 4).
case_images: 3D echocardiogram showing ventricular septal defect (red arrow) and necrosis (black arrow).
case_images: JCHIMP-6-30460-g004.jpg
case_images: PMC4763561_01_JCHIMP-6-30460-g004.jpg
case_images: F0004
case_images: TEE also showed mildly reduced RV systolic function and moderate to severe tricuspid regurgitation (Figs. 3 and 4).