An autopsy case of incomplete left atrial rupture following left atrial infarction associated with left ventricular myocardial infarction
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K Chida1, S Ohkawa, K Nagashima
1Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan.
Insights
A 78-year-old woman experienced incomplete left atrial rupture due to myocardial infarction. Autopsy revealed a hemopericardium and a large hematoma dissecting the left atrial wall, leading to rupture.
Area of Science:
- Cardiology
- Pathology
Background:
- Myocardial infarction can lead to cardiac rupture.
- Left atrial infarction is a rare complication.
Observation:
- A 78-year-old female patient presented with symptoms suggestive of myocardial infarction.
- Autopsy revealed hemopericardium, a large hematoma in the left atrium's posterior wall, and small tears.
- The left circumflex artery showed severe sclerosis and acute thrombus occlusion.
Findings:
- Histologic examination confirmed intramural hematoma dissecting the left atrial wall to the pericardium, causing rupture.
- Coagulation necrosis and intramyocardial hemorrhage were present in the left atrium and left ventricle.
Implications:
- This case highlights a rare mechanism of cardiac rupture secondary to left atrial infarction.
- Understanding these pathways is crucial for diagnosing and managing complex myocardial infarction cases.
Abstract:
We report a 78-year-old woman with incomplete left atrial rupture following left atrial infarction associated with left ventricular myocardial infarction. An autopsy revealed a hemopericardium. A large hematoma was observed in the posterior wall of the left atrium and a few small tears were found on the same wall. Near its origin, the left circumflex artery was severely sclerotic and completely occluded by fresh thrombus. Histologic examination revealed that large intramural hematoma longitudinally dissected the inner third of the posterior wall of the left atrium, and transversely dissected through the necrotic tissue to the pericardial sac to result in rupture. Coagulation necrosis and intramyocardial hemorrhage were also observed throughout the entire left atrium and the postseptolateral wall of the left ventricle.