Acute Left Ventricular Rupture Following Posterior Wall Myocardial Infarction

Huang, Chi Ming; Chen, Liwei; Huang, Sung‐Hao; Huang, Shuai; Wang, Kang-Ling; Chiang, Chern‐En

doi:10.2169/internalmedicine.49.3426

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…4 Usually, rupture follows the first episode and is more common after anterior or inferior infarctions. 5 Our patient had a blow-out rupture, and timely intervention resulted in a successful outcome. Studies have shown that decreased revascularization leads to a higher incidence of free wall rupture.…”

Section: Discussionmentioning

confidence: 64%

Ischemic posterior wall cardiac rupture: early intervention is key for success

Khazi

Zamkan

Abdelaziz

et al. 2019

Asian Cardiovasc Thorac Ann

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Posterior left ventricular free wall rupture is rare, difficult to diagnose, and potentially fatal secondary to tamponade. The optimal surgical technique is controversial, and the outcome depends on the severity of the rupture. A 51-year-old man with acute myocardial infarction complicated by posterior wall rupture presented in extremis with retrosternal pain. Transthoracic echocardiography confirmed the finding with pericardial effusion. The patient underwent successful emergency surgical repair. Although successful salvage following surgical repair remains relatively rare, timely diagnosis with effective communication, use of imaging modalities, and an optimal surgical technique can lead to earlier intervention, thus increasing the possibility of survival.

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Section: Discussionmentioning

confidence: 64%

Ischemic posterior wall cardiac rupture: early intervention is key for success

Khazi

Zamkan

Abdelaziz

et al. 2019

Asian Cardiovasc Thorac Ann

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“…We summarized these three case reports in Table 1 Three key points must be considered when treating cardiac tamponade due to rupture of the heart. First, pericardiocentesis may not be effective for the resolution of hemoperricardium due to the presence of a thrombus, in which pericardiocentesis would not be effective [1,4,11,12]. Accordingly, urgent pericardiotomy is necessary if pericardiocentesis cannot retrieve blood within the pericardial sac causing hemotamponade.…”

Section: Discussionmentioning

confidence: 99%

“…Rupture of the left ventricle free wall is a catastrophic complication in patients suffering from acute myocardial infarction (AMI). In the reperfusion era, its incidence is approximately 3% and accounts for 12% mortality and up to 60% of in-hospital deaths in patients presenting in a state of shock [1]. Most patients succumb to rapid deterioration and instantaneous death; few have a less acute course that leads to a series of diagnostic procedures with subsequent intervention.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Cardiac Tamponade due to Rupture of the Heart Performing an Open-chest Pericardiotomy

Yatsu

Yanagawa

Nagasawa

et al. 2020

Cureus

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A 78-year-old woman with mild dementia was found unconscious by her family. She was transported by an ambulance to our emergency room (ER). Initially, she was comatose and in a state of shock. The echocardiographic findings suggested cardiac tamponade by hematoma. Computed tomography also showed tamponade without aortic dissection. After imaging, she went into cardiac arrest, was returned to the ER, and tracheal intubation and left thoracotomy for pericardiotomy were performed. A return of spontaneous circulation was obtained by following this procedure. Bleeding from a rupture of the left cardiac free wall was confirmed, and the rupture was closed with TachoSil®. After closing the thoracotomy, electrocardiography revealed ST elevation in the precordial leads. Subsequently, placement of an indwelling intraaortic balloon pump and coronary angiography (CAG) were performed. CAG showed an occlusion of the anterior interventricular branch and circumflex branch of the left coronary artery. She underwent conservative therapy in a coronary care unit. Finally, after obtaining hemodynamic stability and baseline mental status, she was transferred to another medical facility. We herein report a rare case involving the successful treatment of cardiac tamponade due to rupture of the heart performing an open-chest pericardiotomy and additionally discuss the key points for obtaining a favorable outcome.

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“…More commonly, it involves the anterior wall of the LVwith the poor collateral flow in the LAD territory being one of the possible explanations (1). No echocardiographic finding specific to cardiac rupture has been reported thus far; nonetheless, a previous investigation has reported LV hyperkinetic wall motion observed in non-infarcted areas neighboring the necrotic region (2).…”

Section: Discussionmentioning

confidence: 99%

Strain Echocardiography Immediately Before Acute Left Ventricular Rupture Following Anterior Wall Myocardial Infarction

Wejner‐Mik¹,

Lipiec²,

Szymczyk³

et al. 2017

Arch Cardiovasc Imaging

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Introduction: Left ventricular (LV) free wall rupture is a rare but catastrophic complication of acute ST-elevation myocardial infarction (STEMI) and is still present in the era of aggressive reperfusion therapy. Case Presentation: An 81-year-old man with a history of hypertension and dyslipidemia was admitted to our hospital with anterior STEMI. While being prepared for coronary angiography, the patient underwent a focused 2D and Doppler echocardiographic study, which revealed akinesis in the apical segments of the LV and hyperkinesis in the adjacent segments, with a mild impairment in the LV ejection fraction (46%). This pattern of regional wall motion abnormalities was confirmed by speckle-tracking echocardiography. Fifteen minutes after hospital admission, he suffered sudden cardiac arrest, for which resuscitation was commenced immediately. Repeat echocardiography revealed massive pericardial effusion, resulting in cardiac tamponade. Pericardiocentesis was performed, but the ensuing resuscitation efforts were unsuccessful. Conclusions: We present a unique recording and quantitative analysis of the LV wall motion abnormalities immediately preceding free wall rupture in nonrevascularized anterior STEMI. We hypothesize that significant differences in the regional function, ranging from an akinetic apex to hypercontractile segments adjacent to the necrotic zone, can represent a marker of threatened cardiac rupture.

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Acute Left Ventricular Rupture Following Posterior Wall Myocardial Infarction

Cited by 5 publications

References 26 publications

Ischemic posterior wall cardiac rupture: early intervention is key for success

Ischemic posterior wall cardiac rupture: early intervention is key for success

Successful Treatment of Cardiac Tamponade due to Rupture of the Heart Performing an Open-chest Pericardiotomy

Strain Echocardiography Immediately Before Acute Left Ventricular Rupture Following Anterior Wall Myocardial Infarction

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