Myocardial rupture with cardiac tamponade as a lethal early manifestation of acute myeloblastic leukemia

A 73-year-old woman presented with a two-week history of increasing lassitude and fever. The hemoglobin level was 152 g/l and the total leucocyte count was 348 X 10(9)/l with 97% blasts. Before the diagnosis of acute leukemia could be confirmed by bone marrow examination, the patient developed shock and died within a few minutes. At autopsy a myocardial rupture of the left lateral wall apparently due to a massive leukemic infiltration was found.

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