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Incomplete myocardial rupture after coronary embolism of an isolated single coronary artery

Javier Pindado1, Pedro Marcos-Alberca, Manuel Rey

  • 1Servicio de Cardiología, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|January 25, 2005
PubMed

Insights

An elderly woman experienced a myocardial infarction due to left main coronary artery occlusion, likely from a blood clot. Echocardiography revealed a contained myocardial wall rupture, leading to fatal cardiogenic shock.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • An 82-year-old female presented with anterior wall myocardial infarction and cardiogenic shock.
  • The patient had a history of chronic atrial fibrillation without oral anticoagulation.

Observation:

  • Coronary angiography revealed left main coronary artery occlusion originating from the right sinus of Valsalva.
  • Transthoracic echocardiography demonstrated an incomplete contained rupture of the interventricular septum's apical portion.

Findings:

  • The clinical presentation, atrial fibrillation, and normal coronary arteries suggested a thromboembolic etiology.
  • The contained rupture contributed to extensive left ventricular damage.

Implications:

  • This case highlights a rare cause of myocardial infarction and cardiogenic shock.
  • Prompt diagnosis and management of thromboembolic events in patients with atrial fibrillation are crucial.
  • Understanding contained myocardial rupture is vital for managing complex cardiac emergencies.

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