An unusual presentation of left ventricular free wall rupture

Left ventricular free wall rupture (LVFWR) is one of the most lethal complications following myocardial infarction. It accounts for approximately 12% to 21% of all in-hospital deaths following myocardial infarction. The majority of patients die shortly after LVFWR from instantaneous pericardial tamp...

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Bibliographic Details
Published in:Canadian journal of cardiology 2010-10, Vol.26 (8), p.e328-e329
Main Authors: Han, Cecelia S.Y., BSc MD, Bohonis, Sheena, BSc, Walker, Jonathan R., BSc, Vo, Minh, MD FRCPC, Hussain, Farrukh, MD FRCPC, Pascoe, Edward, MD FRCSC, Jassal, Davinder S., MD FRCPC
Format: Article
Language:English
Subjects:
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Cardiac Catheterization
Cardiac Surgical Procedures - methods
Cardiac Tamponade - diagnosis
Cardiac Tamponade - etiology
Cardiac Tamponade - surgery
Cardiovascular
Case Report
Diagnosis, Differential
Echocardiography
Electrocardiography
Follow-Up Studies
Heart Rupture - complications
Heart Rupture - diagnosis
Heart Rupture - surgery
Heart Ventricles
Hemopericardium
Humans
Male
Mechanical complications
Myocardial infarction
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Summary:Left ventricular free wall rupture (LVFWR) is one of the most lethal complications following myocardial infarction. It accounts for approximately 12% to 21% of all in-hospital deaths following myocardial infarction. The majority of patients die shortly after LVFWR from instantaneous pericardial tamponade and hemodynamic collapse. However, up to one-third of cases are subacute in nature, allowing limited time for emergent surgical repair to prevent sudden death. A high index of suspicion and timely use of diagnostic tests are important in recognizing cases. The present report describes the case of a 69-year-old man who initially presented with acute pericardial tamponade and was subsequently diagnosed with LVFWR in the operating room as the cause of his hemopericardium. The pathology, diagnosis and management of LVFWR are reviewed.
ISSN:0828-282X
1916-7075
DOI:10.1016/S0828-282X(10)70446-3