Sudden Death Due to Cardiac Tamponade Secondary to Myocardial Infarction Ventricular Wall Rupture

Patil, Amit B; Singh, Nawal Kumar; Vigneshwaran, S; Bharti, Shreekant; Sudhakar, Shreepriya

doi:10.7759/cureus.30288

Cited by 3 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The venous drainage is dammed back so that congestion and cyanosis of the face and neck occur until a fatal endpoint is reached. 6 The absence of symptoms often associated with myocardial ischemia is referred to as a silent myocardial infarction. Silent myocardial infarction is thought to occur in 2%-4% of young adult asymptomatic men.…”

Section: Discussionmentioning

confidence: 99%

“…As input volume falls, so does stroke output. The venous drainage is dammed back so that congestion and cyanosis of the face and neck occur until a fatal endpoint is reached 6 …”

Section: Discussionmentioning

confidence: 99%

“…Sudden death can be the initial indication of an underlying illness in individuals who were previously asymptomatic and appeared to be in good health. In such cases, an autopsy is essential as it provides the first and only opportunity to accurately determine and record the cause of death 6 . In such cases, pathologists play a critical role in discriminating between myocardial infarction as the cause of death and other potential causes, such as myocardial injury.…”

Section: Introductionmentioning

confidence: 99%

“…Pathologists are responsible for the histological identification and timing of myocardial infarction in humans, but achieving precision in these tasks can be difficult 5 . Proper knowledge of ischemic coronary pathology, guided by appropriate interpretation through correlation with the clinical scenario of the deceased, is necessary to achieve precision 6 . Cardiac tamponade is a significant factor contributing to sudden cardiac death, often identified as the fatal outcome during autopsy 6 .…”

Section: Introductionmentioning

confidence: 99%

“…In such cases, an autopsy is essential as it provides the first and only opportunity to accurately determine and record the cause of death. 6 In such cases, pathologists play a critical role in discriminating between myocardial infarction as the cause of death and other potential causes, such as myocardial injury. Even with the expertise of distinguished pathologists, the diagnosis of myocardial infarction in the absence of acute coronary occlusion remains challenging.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ventricular silent rupture leading to sudden death: Navigating diagnostic challenges in a resource‐constraint setting

Pallangyo,

Pyuza,

Nkya

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageVentricular myocardial rupture is a rare complication of myocardial infarction. It occurs within hours to weeks after an infarction. Mortality is high. Antemortem diagnosis is a challenge in low‐resource settings, leading to potential misdiagnosis.AbstractLeft ventricular myocardial rupture is a potentially fatal yet common complication in acute myocardial infarction patients. Rupture can occur as early as hours after an infarction. However, rupture may also occur later in the first week in the setting of myocardial necrosis and neutrophilic infiltration. Patients may survive several days to weeks before rupture occurs, and cardiac tamponade may present subacutely with a slow or repetitive clinical course. Sudden death can be attributed to ventricular rupture, more commonly during this time frame. Myocardial rupture can also occur as a result of trauma, infections, or cancer. Mortality is exceedingly high if surgical intervention is delayed. In most patients, myocardial rupture manifests as a catastrophic event within days of a first, small, uncomplicated acute myocardial infarction. Acute onset of shortness of breath, chest pain, shock, diaphoresis, unexplained emesis, cool and clammy skin, and syncope may herald the onset of ventricular septal rupture after acute myocardial infarction. Sudden death from myocardial rupture during acute myocardial infarction in patients with no apparent previous symptoms of myocardial ischemia represents a challenge for medical examiners, law enforcement officers, and society as a whole. An autopsy is critical for establishing the cause of death. We present the case of a 54‐year‐old male whose body was found beside the road after a trivial quarrel a day before. Further medical information about the deceased was not available. The preliminary cause of death was presumed to be traumatic. No evidence of trauma was seen during the autopsy. Massive pericardial blood collection compressing the heart and concealed left ventricular myocardial rupture were noted. Histopathological examination of the heart demonstrated myocardial infarction with a tear associated with bleeding that was contained in the pericardial sac. We ruled cardiac tamponade as the cause of death due to an infarcted myocardial rupture. Antemortem diagnosis of myocardial rupture can be challenging in low‐resource settings, leading to potential misdiagnosis and negative impacts such as community conflicts.

show abstract

Section: Discussionmentioning

confidence: 99%

“…As input volume falls, so does stroke output. The venous drainage is dammed back so that congestion and cyanosis of the face and neck occur until a fatal endpoint is reached 6 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ventricular silent rupture leading to sudden death: Navigating diagnostic challenges in a resource‐constraint setting

Pallangyo,

Pyuza,

Nkya

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Cardiac Tamponade and Myocardial Infarction: A Case Report

Angel,

Pradhan

2024

Cureus

View full text Add to dashboard Cite

In recent times, there has been a concerning rise in the incidence of sudden death among individuals in middle age. Predominantly, cardiovascular diseases emerge as the leading cause behind such untimely fatalities. Myocardial infarction and its subsequent complications stand out as the most frequently encountered scenarios in these tragic events. Despite being a relatively uncommon occurrence, cardiac tamponade represents one of the rare yet fatal complications that can ensue following a myocardial infarction. This condition manifests when the pericardial cavity becomes filled with either blood or blood clots, impeding the heart's normal functioning. Typically, patients experiencing cardiac tamponade are often reported to have succumbed to sudden death, with a preceding history of chest pain being a common indicator. The definitive diagnosis of cardiac tamponade usually occurs during post-mortem examinations. We consider the case of a 38-year-old man who was discovered unconscious at his residence and was pronounced dead upon arrival at the hospital. Subsequent autopsy findings unveiled the presence of both blood and blood clots within the pericardial cavity, in conjunction with a rupture in the right ventricle and occlusion of the left coronary artery. Histopathological analysis further confirmed the root cause of this tragic event as an acute myocardial infarction.

show abstract

Assessment of Myocardial Ischemia Using Coronary Postmortem Computed Tomography Angiography Based on the Voronoi Algorithm: A Case Report

Fukuda,

Tokue,

Shiraishi

et al. 2024

Cureus

View full text Add to dashboard Cite

Postmortem computed tomography angiography (PMCTA) is a valuable tool for diagnosing vascular conditions, such as hemorrhages, in trauma cases. This case report demonstrates the use of the Voronoi algorithm to assess myocardial ischemia using coronary PMCTA. A male in his 70s was found unconscious in a car after colliding with a traffic light pole. Despite medical interventions, including pericardial drainage and cardiopulmonary resuscitation, the patient died two hours later. PMCTA revealed significant filling defects in the left anterior descending artery (LAD), consistent with plaque rupture and narrowing observed during autopsy. The cause of death in this case was likely cardiac tamponade due to cardiac rupture secondary to myocardial infarction resulting from LAD stenosis. Cardiac perfusion areas were analyzed using the Voronoi algorithm, demonstrating a total myocardial volume of 151.9 mL in the left ventricle. Perfusion volumes were calculated as 92.9 mL (61.2%) for the LAD, 34.2 mL (22.5%) for the left circumflex artery, and 24.9 mL (16.4%) for the right coronary artery. The predicted ischemic volume distal to the LAD stenosis was estimated to be 49.8 mL (32.8%). Furthermore, the ischemic areas observed during autopsy macroscopically corresponded well with the predicted ischemic regions. This case highlights that combining PMCTA with the Voronoi algorithm provides an accurate method for assessing myocardial ischemic areas, offering a non-invasive approach to visualize and quantify perfusion and ischemic regions.

show abstract

Sudden Death Due to Cardiac Tamponade Secondary to Myocardial Infarction Ventricular Wall Rupture

Cited by 3 publications

References 10 publications

Ventricular silent rupture leading to sudden death: Navigating diagnostic challenges in a resource‐constraint setting

Ventricular silent rupture leading to sudden death: Navigating diagnostic challenges in a resource‐constraint setting

Cardiac Tamponade and Myocardial Infarction: A Case Report

Assessment of Myocardial Ischemia Using Coronary Postmortem Computed Tomography Angiography Based on the Voronoi Algorithm: A Case Report

Contact Info

Product

Resources

About