Left ventricular rupture

Case contributed by Dr Mate Kover

Presentation

During the night, the patient collapsed, he lost his consciousness, and he had chest pain. ECG showed lateral STEMI, the patient was taken to the ER. When he arrived to the ER, he only had chest pain.

Patient Data

Age: 70 years
Gender: Male
CT

On the non- contrast phase study we can see the there is around 15 mm thick pericardial fluid, which is slightly hyperdense. The aorta has a normal diameter, the wall is sclerotic. On the arterial phase, it is visible that the contrast material exits through the ruptured left ventricle into the pericardium.

Case Discussion

Acute left ventricular rupture is a rare complication of myocardial infarction with high mortality. Nowadays, in the era of percutaneous coronary intervention and aggressive pharmacological therapy, the incidence of this complication massively decreased (~1%). Urgent surgery was needed and performed, but even so, the patient died.

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Case information

rID: 71145
Published: 22nd Sep 2019
Last edited: 25th Sep 2019
System: Cardiac
Inclusion in quiz mode: Included
Institution: Hungarian Defence Forces Medical Center

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