Unveiling a rare case: Cardiac rupture secondary to acute occlusion of the distal left circumflex artery detected by contrast-enhanced spiral CT

Yiqing Hu; Junzhen Liu; Juying Qian; Hao Lu; Junbo Ge

doi:10.1016/j.heliyon.2023.e18460

Unveiling a rare case: Cardiac rupture secondary to acute occlusion of the distal left circumflex artery detected by contrast-enhanced spiral CT

Heliyon. 2023 Jul 27;9(8):e18460. doi: 10.1016/j.heliyon.2023.e18460. eCollection 2023 Aug.

Authors

Yiqing Hu^{1

2

3}, Junzhen Liu⁴, Juying Qian^{1

2

3}, Hao Lu^{1

2

3}, Junbo Ge^{1

2

3}

Affiliations

¹ Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China.
² National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
³ Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
⁴ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.

Abstract

A 79-year-old female patient was admitted to the hospital due to intense chest pain. Emergency percutaneous coronary intervention (PCI) revealed an occlusion in the distal portion of the left circumflex artery (LCx). The patient suffered from cardiac rupture, an uncommon yet extremely perilous condition, within 30 minutes following the procedure. This was verified through a computed tomography angiography (CTA) scan and bedside echocardiography. The etiology of cardiac rupture remains elusive, yet potential factors such as the patient's age, gender, initial acute myocardial infarction (AMI), and single-vessel disease without collateral circulation may be linked to this occurrence. This case report emphasizes that occluded tiny distal coronary arteries can also induce cardiac rupture and that a sufficient level of suspicion for the diagnosis of cardiac rupture should be raised when adequate fluid resuscitation fails to alleviate hypotension. Additionally, contrast-enhanced spiral computed tomography (CESCT) is highly effective in revealing certain pathological features associated with cardiac rupture.

Keywords: Acute myocardial infarction; Cardiac rupture; Contrast-enhanced spiral CT; Tiny distal coronary arteries.

Publication types

Case Reports