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Self-limiting left ventricular wall rupture following myocardial infarction: a case report and literature review

Hannes Vervaeke, Nathalie Becaus, Martin Penicka

    Acta Cardiologica
    |May 3, 2014
    PubMed

    Insights

    A rare complication of heart attack, left ventricular free wall rupture, can sometimes self-limit. This case shows a patient recovering with medical treatment due to spontaneous clot formation.

    Area of Science:

    • Cardiology
    • Cardiovascular Medicine
    • Medical Case Reports

    Background:

    • Left ventricular free wall rupture is a rare but often fatal complication of acute myocardial infarction.
    • It typically leads to haemopericardium and cardiac tamponade.

    Observation:

    • A 62-year-old woman presented with myocardial infarction and signs of left ventricular free wall rupture.
    • Coronary angiography identified critical stenosis in the right coronary artery.
    • A ventriculogram showed contrast extravasation through the inferolateral wall.

    Findings:

    • The patient experienced a small rupture, which appeared to self-limit.
    • Spontaneous closure was likely facilitated by epicardial fibrin deposits and clot formation at the rupture site.
    • The patient improved with intensive medical management alone, avoiding surgery.

    Implications:

    • This case highlights that not all left ventricular free wall ruptures require surgical intervention.
    • Conservative management may be successful in select cases with small, self-sealing ruptures.
    • Understanding spontaneous healing mechanisms is crucial for optimizing treatment strategies.

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