Rupture of the inter-ventricular septum.

Rupture of the infarcted interventricular septum was first described more than a century ago in this country (Latham, 1846). The subject was last reviewed by Fowler and Failey (1948), who discovered 56 recorded cases, of which 16 were diagnosed during life. Since their review, single cases have been described by Sweeny (1948), Bickerman and Irons (1949), Shapir (1949), Ungar and Ullman (1950), and Muller et al. (1950) and two by Furman and Meneeley (1948). All of these were diagnosed during life. Thus, until the time of writing, 23 out of 63 cases were correctly diagnosed before death. A further example in which a diagnosis of ruptured septal infarction was made, before death, is recorded here. The physical signs were noted in 51 of these cases. In 49 there were systolic murmurs, with associated thrills in 24. In 4 there were diastolic murmurs, in 2 there were no abnormal auscultatory signs to suggest the lesion, and in the remaining 13 the physical signs were not recorded.