Survival after left ventricular free wall rupture following acute myocardial infarction by conservative treatment

Am J Emerg Med. 2021 Jan:39:21-23. doi: 10.1016/j.ajem.2020.08.035. Epub 2020 Aug 15.

Abstract

Left ventricular free wall rupture (LVFWR) is a rare and fatal mechanical complication following an acute myocardial infarction (AMI). Cases of survival after LVFWR due to ST-segment elevation myocardial infarction (STEMI) treated with a conservative treatment strategy are extremely rare. In this case, a 55-year-old male patient with several cardiovascular risk factors presented to the emergency department with symptoms of ongoing chest pain and syncope. The patient's electrocardiogram was in sinus rhythm with ST-elevation on I, aVL, and V4-6 leads. His myoglobin and troponin I levels were elevated. Due to the unstable hemodynamic state of the patient, bedside echocardiography was performed. The echocardiography indicated LVFWR after AMI. Pericardiocentesis was used to restore a satisfactory hemodynamic state in the patient. Following the initial treatment, the patient opted for a conservative treatment strategy and was uneventfully discharged after 19 days.

Keywords: Acute myocardial infarction; Bedside echocardiography; Left ventricular free wall rupture; Pericardiocentesis.

Publication types

  • Case Reports

MeSH terms

  • Conservative Treatment
  • Echocardiography
  • Electrocardiography
  • Heart Rupture, Post-Infarction / diagnostic imaging*
  • Heart Rupture, Post-Infarction / etiology*
  • Heart Rupture, Post-Infarction / therapy
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnostic imaging*
  • Pericardiocentesis
  • Treatment Outcome