Left ventricular rupture
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During the night, the patient collapsed, lost his consciousness and had chest pain. ECG showed lateral STEMI, and the patient was taken to the ER. When he arrived at the ER, he only had chest pain.
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On the non-contrast phase study, we can see around 15 mm thick pericardial fluid, which is slightly hyperdense. The aorta has a normal diameter; the wall is sclerotic. It is visible that the contrast material exits through the ruptured left ventricle into the pericardium on the arterial phase.
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, this complication's incidence massively decreased (~1%). Urgent surgery was needed and performed, but even so, the patient died.
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