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Subacute myocardial rupture following tirofiban treatment

Ozgür Ciftçi1, Murat Günday2, Tonguç Saba2

  • 1Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey.

Research in Cardiovascular Medicine
|December 6, 2014
PubMed

Insights

This case report details a rare instance of tirofiban-induced ventricular free wall rupture following percutaneous coronary intervention. The patient

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Post-myocardial infarction (MI) angina necessitates prompt intervention.
  • Percutaneous coronary intervention (PCI) with stenting is a common treatment.
  • Antiplatelet and anticoagulant therapies, including tirofiban, are crucial post-PCI.

Observation:

  • The patient received standard medical treatment, including acetylsalicylic acid, clopidogrel, metoprolol, atorvastatin, enoxaparine, and a tirofiban infusion.
  • Within 24 hours, the patient developed acute dyspnea, hypotension, and tachycardia, indicative of a serious complication.

Findings:

  • Echocardiography confirmed a large pericardial effusion.
  • Surgical exploration revealed ventricular free wall rupture, which was successfully repaired using a multi-layered Surgicel patch and tissue glue without cardiopulmonary bypass.

Implications:

  • This case represents the first reported instance of tirofiban-induced ventricular free wall rupture.
  • Clinicians should be vigilant for this rare but life-threatening complication in patients receiving tirofiban, particularly after percutaneous coronary interventions.

Keywords:
EmergenciesRuptureTirofiban

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