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Right ventricular free wall dissection as a rupture tract in left ventricular rupture during acute myocardial

Aya Takada1, Kazuyuki Saito2, Tatsuya Murai3

  • 1Department of Forensic Medicine, Saitama Medical University, Saitama, Japan; Tokyo Medical Examiner's Office, Tokyo, Japan.

Legal Medicine (Tokyo, Japan)
|November 24, 2015
PubMed

Insights

Rare cardiac rupture involving right ventricular wall dissection during acute myocardial infarction (AMI) was observed in three cases. This dissection, occurring between myocardial layers, led to both early and delayed ruptures.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Acute myocardial infarction (AMI) can lead to cardiac rupture, a life-threatening complication.
  • Cardiac rupture with right ventricular (RV) wall dissection is an exceptionally rare event.

Observation:

  • Three cases of cardiac rupture with RV wall dissection during AMI were identified.
  • These cases represented 2% of previously reported postinfarction cardiac ruptures associated with sudden death.

Findings:

  • Dissections occurred in hearts with biventricular inferior wall AMI, developing between superficial and deeper layers of the RV inferior wall.
  • All cases exhibited an endocardial tear at the basal septum (LV junction) and an epicardial tear on the RV inferior wall.
  • Evidence of thrombi ages indicated both early RV dissection and delayed epicardial rupture.

Implications:

  • This study highlights a rare but severe mechanism of cardiac rupture following AMI.
  • Understanding the layered dissection and timing of rupture is crucial for diagnosing and managing these critical cardiac events.
Keywords:
Cardiac ruptureDissectionIntramyocardial dissecting hematomaMyocardial infarctionRight ventricleSudden death

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