Appropriate Surgical Repair of Ventricular Free Wall Rupture after Infarction: a Case Report
Umut Serhat Sanrı1, Kadir Kaan Özsin1, Faruk Toktaş1
1University of Health Sciences Bursa Yüksek İhtisas Research and Trainning Hospital Department of Cardiovascular Surgery Bursa Turkey Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yüksek İhtisas Research and Trainning Hospital, Bursa, Turkey.
Abstract:
Ventricular free wall rupture is a fatal mechanical complication of acute myocardial infarction. In some cases it can be represented as subacute clinic and may not cause death in a few minutes. Acute pseudo-aneurysms are extremely unstable and bound to fatal rupture. Herein we report a male patient who suffered dyspnea and mild chest pain, 4 weeks after acute ST-segment elevation myocardial infarction.
Insights
Ventricular free wall rupture, a rare complication of myocardial infarction, can present subacutely. This case highlights a patient with delayed rupture presenting as a pseudoaneurysm four weeks post-infarction.
Area of Science:
- Cardiology
- Cardiac Surgery
- Internal Medicine
Background:
- Ventricular free wall rupture (VFWR) is a life-threatening mechanical complication following acute myocardial infarction (AMI).
- While often presenting acutely, VFWR can manifest with subacute clinical symptoms, delaying diagnosis and treatment.
- Pseudoaneurysms represent a particularly unstable form of VFWR, carrying a high risk of catastrophic rupture.
Observation:
- This report details a male patient experiencing dyspnea and mild chest pain.
- These symptoms emerged four weeks after an initial acute ST-segment elevation myocardial infarction (STEMI).
- The clinical presentation suggested a potential subacute mechanical complication rather than immediate fatal rupture.
Findings:
- The patient's delayed presentation 4 weeks post-STEMI was attributed to a ventricular pseudoaneurysm.
- This pseudoaneurysm, a consequence of subacute VFWR, remained unstable despite the time elapsed since the initial infarction.
- The case underscores the potential for delayed and less immediately dramatic presentations of VFWR.
Implications:
- Recognizing subacute presentations of VFWR is crucial for timely intervention.
- Pseudoaneurysm formation necessitates urgent evaluation and management to prevent fatal re-rupture.
- This case emphasizes the importance of considering mechanical complications beyond the acute phase of myocardial infarction.
