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Early diagnosis and management of myocardial rupture

Shuangbo Liu1, Tamara Glavinovic1, James W Tam1

  • 1Section of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

The Canadian Journal of Cardiology
|December 31, 2014
PubMed

Insights

Left ventricular free wall rupture, a rare complication of myocardial infarction, was diagnosed in an 82-year-old woman using contrast echocardiography. Prompt surgical repair led to immediate hemodynamic improvement and successful recovery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Left ventricular free wall rupture is a life-threatening mechanical complication following myocardial infarction.
  • Early diagnosis and intervention are critical for patient survival.

Observation:

  • An 82-year-old woman presented with an anterolateral ST-elevation myocardial infarction treated with thrombolysis.
  • Unexplained hypotension prompted echocardiography with contrast (Definity) for enhanced visualization.

Findings:

  • Echocardiography revealed a circumferential pericardial effusion without tamponade.
  • Intramyocardial tracking of contrast into the epicardial space indicated wall rupture in the anterior septum.

Implications:

  • Contrast-enhanced echocardiography can aid in diagnosing subtle cases of left ventricular free wall rupture.
  • Timely surgical intervention, including clot evacuation and wall repair, can lead to immediate hemodynamic stability and successful outcomes.

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