Successful emergency surgical intervention in acute non-ST-segment elevation myocardial infarction with rupture: A...

The incidence of acute myocardial infarction (AMI) is rising, with cardiac rupture accounting for approximately 2% of deaths in patients with acute ST-segment elevation myocardial infarction (STEMI). Ventricular free wall rupture (FWR) occurs in approximately 2% of AMI patients and is notably rare in patients with non-STEMI. Types of cardiac rupture include left ventricular FWR, ventricular septal rupture, and papillary muscle rupture. The FWR usually leads to acute cardiac tamponade or electromechanical dissociation, where standard resuscitation efforts may not be effective. Ventricular septal rupture and papillary muscle rupture often result in refractory heart failure, with mortality rates over 50%, even with surgical or percutaneous repair options.

We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary angiography. Prompt resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient recovery.

This case emphasizes the risks of AMI complications, shares a successful treatment scenario, and discusses measures to prevent such complications.