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[Survival after oozing type cardiac rupture associated with subepicardial aneurysm evaluated by echocardiography: a
A Iwata1, K Takazawa, K Teraoka
1Second Department of Internal Medicine, Tokyo Medical University, Nishi-shinjuku 6-7-1, Shinjuku-ku, Tokyo 160-0023.
Insights
A 64-year-old woman experienced cardiac rupture after myocardial infarction. Serial echocardiography accurately diagnosed this rare condition, enabling successful surgical intervention.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Acute myocardial infarction (AMI) is a leading cause of cardiovascular mortality.
- Complications such as cardiac rupture, though rare, carry a high mortality rate.
- Early and accurate diagnosis is critical for timely intervention in post-MI complications.
Observation:
- A 64-year-old woman presented with AMI and underwent percutaneous transluminal coronary angioplasty.
- Serial transthoracic echocardiography revealed progressive pericardial effusion.
- Echocardiography demonstrated left ventricular apical myocardial discontinuity with intact epicardium and systolic expansion, suggestive of cardiac rupture.
Findings:
- The echocardiographic findings led to the diagnosis of an oozing-type cardiac rupture originating from a subepicardial aneurysm.
- Surgical intervention was performed successfully.
- The case highlights the diagnostic accuracy of echocardiography in identifying rare cardiac complications.
Implications:
- This case underscores the importance of serial echocardiography in evaluating suspected cardiac complications post-myocardial infarction.
- Accurate echocardiographic diagnosis of cardiac rupture, even in its rarer forms, is crucial for guiding surgical management.
- Successful surgical repair demonstrates the feasibility of treating complex cardiac ruptures.
Abstract:
A 64-year-old woman was admitted to our hospital with acute myocardial infarction. She underwent emergent percutaneous transluminal coronary angioplasty. Transthoracic echocardiography revealed mild pericardial effusion on the third day. Pericarditis or cardiac rupture were suspected, so transthoracic echocardiography was repeated serially. On the sixth day, transthoracic echocardiography showed increasing pericardial effusion and abrupt interruption of the apical myocardium of the left ventricle and intact epicardial imaging with systolic expansion. The diagnosis was oozing type cardiac rupture of a subepicardial aneurysm. Surgical treatment was successful and the accuracy of the echocardiographic diagnosis was established.