Incomplete myocardial rupture following inferior myocardial infarction: A case report

Comparison of distinctive clinical and cardiac magnetic resonance features between ST elevation myocardial infarction patients with incomplete myocardial rupture and those with moderate to severe pericardial effusion

“…1 Indeed, based on autopsy and surgical series, PE has often been associated with left ventricular free wall rupture (FWR) [1][2][3][4] and less frequently with pericarditis. 2 On the other hand, isolated cases of incomplete myocardial rupture (IMR), as documented by echocardiography, [5][6][7][8][9][10][11] contrast left ventriculography 6,11,12 or cardiac magnetic resonance (CMR), 6,8,10,11 have also been reported and may also evolve to complete rupture and tamponade. 5,13,14 However, a comparison of the clinical and CMR profile of patients with PE with those of patients with IMR to identify potential similarities has not been performed.…”

Contained Myocardial Rupture

“…Myocardial rupture occurs in 1% to 2% of cases of acute myocardial infarction (AMI) (1, 2). After cardiogenic shock, myocardial rupture represents the second leading cause of in-hospital mortality in patients with AMI (3). Myocardial ruptures may be complete, incomplete, or contained, with contained ruptures representing an intermediate entity between the former two (3).…”

“…After cardiogenic shock, myocardial rupture represents the second leading cause of in-hospital mortality in patients with AMI (3). Myocardial ruptures may be complete, incomplete, or contained, with contained ruptures representing an intermediate entity between the former two (3). Presented herein are gross and histologic photographs of a contained myocardial rupture in a patient who died following AMI.…”

“…It has been postulated that there is clinical relevance in distinguishing contained from complete myocardial rupture, as the epicardial roof likely confers some degree of protection against a hemopericardium (3,4). Of note, the pericardial sac in the present case was free of hemorrhage.…”

“…Of note, the pericardial sac in the present case was free of hemorrhage. While imaging modalities may not always be able to reliable distinguish between these two entities (3,4), contained rupture has been recently documented via magnetic resonance imaging (5).…”