Left Ventricular Free Wall Rupture in Transmural Myocardial Infarction

Khalid, Sidra; Seepana, Jyothirmai; Sundhu, Murtaza; Maroo, Praful

doi:10.7759/cureus.1610

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Due to the poor prognosis and high peri-operative mortality, free wall myocardial ruptures witnessed even in hospitals are left and no surgical correction is done [10]. Here, we highlight the timely management of an outside hospital subacute cardiac rupture post-MI with cardiogenic shock.…”

Section: Discussionmentioning

confidence: 92%

Perioperative Management of a Patient With Left Ventricular Free Wall Rupture After Myocardial Infarction: A Rare Case Scenario

Panesar¹,

Bhende²,

Sharma³

et al. 2022

Cureus

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Myocardial infarction (MI) is typically followed by numerous lethal complications. One such complication is left ventricular free wall rupture (LVFWR). We present the case of a middle-aged hypertensive patient who had a history of unstable angina for seven days. He presented to the emergency room with chest pain, dyspnea, and unstable vital parameters. Clinical signs, electrocardiography, and echocardiography raised the suspicion of left ventricular free wall rupture with ST-segment elevation inferior wall and lateral wall MI. As a result, the patient received aggressive resuscitative measures. Later, he underwent surgical repair for cardiac rupture via cardiopulmonary bypass. Finally, the patient was discharged from the hospital on the 10 th postoperative day. The window period from the onset of cardiac wall rupture to patient admission to the operating room is crucial. This case report highlights that a high index of suspicion for left ventricle free wall rupture should be considered for a patient presenting with MI and cardiogenic shock. Timely diagnosis and quick surgical intervention can deter complications and save the patient.

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Section: Discussionmentioning

confidence: 92%

Perioperative Management of a Patient With Left Ventricular Free Wall Rupture After Myocardial Infarction: A Rare Case Scenario

Panesar¹,

Bhende²,

Sharma³

et al. 2022

Cureus

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Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report

Paz

Río

González-Padilla

et al. 2019

BMC Cardiovasc Disord

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Background There are three major mechanical complications after acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication following an ST elevation myocardial infarction. However, very rarely this rupture can be contained by the pericardium, forming a pseudoaneurysm. Case presentation We report a case of a 66-year-old man with multiple cardiovascular risk factors and previous ST elevation myocardial infarction, complaining of atypical chest pain. His electrocardiogram was in normal sinus rhythm, with the presence of Q wave in inferior leads and T-wave inversion in lateral leads. A transthoracic echocardiogram showed a left ventricular pseudoaneurysm. In the coronary angiography, multi-vessel disease was found. On-pump CABG was performed and a posterolateral left ventricular giant pseudoaneurysm were observed. Due its “petrous” consistency it was impossible to perform an aneurysmectomy. Conclusions The diagnosis of left ventricular pseudoaneurysm can be difficult, as patients often present either asymptomatic or with non-specific symptoms attributed to other causes. A multimodality imaging diagnostic approach can be necessary. Immediate surgery is considered the treatment of choice because untreated pseudoaneurysms have a high risk of rupture leading to cardiac tamponade, shock and death.

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A Third Ventricle?

Ward¹

2019

Annals ATS

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Left Ventricular Free Wall Rupture in Transmural Myocardial Infarction

Cited by 3 publications

References 7 publications

Perioperative Management of a Patient With Left Ventricular Free Wall Rupture After Myocardial Infarction: A Rare Case Scenario

Perioperative Management of a Patient With Left Ventricular Free Wall Rupture After Myocardial Infarction: A Rare Case Scenario

Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report

A Third Ventricle?

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