Conservative therapy for external myocardial rupture in a patient with anterior myocardial infarction: a case report

Introduction. Double heart rupture is a rare complication of acute myocardial infarction with high mortality. Case report. We presented a 67-year-old female patient with symptoms and signs of myocardial infarction, diagnosed with echocardiography, rupture of the septum, the presence of a thrombus and a small pericardial effusion. Soon after admission the patient died. Autopsy revealed tamponade and double myocardial rupture, free wall rupture and ventricular septal rupture, as a cause of death. Conclusion. This case highlights the need to evaluate patients with myocardial infarction, recurrent chest pain, echocardiographic signs of effusion and the presence of thrombus in the pericardium in terms of double rupture of the heart.

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Incomplete myocardial rupture following inferior myocardial infarction: A case report

International Journal of Cardiology ◽

10.1016/j.ijcard.2006.08.075 ◽

2007 ◽

Vol 116 (1) ◽

pp. e27-e28 ◽

Cited By ~ 2

Author(s):

E. Hoffer ◽

P. Materne ◽

E. Lecoq ◽

M. Markov ◽

J. Boland

Keyword(s):

Myocardial Infarction ◽

Case Report ◽

Inferior Myocardial Infarction ◽

Myocardial Rupture

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Myocardial rupture after percutaneous coronary intervention of an unstable RCA lesion in myocardial infarction and concomitant stroke treated with intravenous fibrinolytic agents: A case report

Clinical Case Reports ◽

10.1002/ccr3.3736 ◽

2021 ◽

Author(s):

Benjamin Bay ◽

Christoph Waldeyer ◽

Leander Rimmele ◽

Stefan Blankenberg ◽

Peter Clemmensen

Keyword(s):

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Case Report ◽

Coronary Intervention ◽

Fibrinolytic Agents ◽

Percutaneous Coronary ◽

Myocardial Rupture

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Cardiac Tamponade after an Anterior Myocardial Infarction: A Case Report

10.53902/sojccts.2021.01.000503 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Carolina Romano Ribeiro

Keyword(s):

Myocardial Infarction ◽

Case Report ◽

Cardiac Tamponade ◽

Diagnosis And Treatment ◽

Medical Emergency ◽

Successful Management ◽

Anterior Myocardial Infarction ◽

Ventricular Rupture ◽

Prompt Diagnosis

Cardiac tamponadeis a medical emergency which requires a fast diagnosis and treatment. We report the successful management of 51-year-old women who presented with cardiac tamponade due to ventricular rupture. Once this condition was suspected and confirmed by echocardiography, an emergent pericardiotomy was made. This case highlights the importance of a prompt diagnosis and how this could change the prognosis.

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Coronary dissection with ST elevation myocardial infarction responding to thrombolytic and conservative therapy alone

Future Cardiology ◽

10.2217/fca-2018-0071 ◽

2020 ◽

Vol 16 (4) ◽

pp. 271-274

Author(s):

Morteza Safi ◽

AliReza Serati ◽

Sepideh Emami ◽

Mohammad Reza Movahed

Keyword(s):

Myocardial Infarction ◽

Clinical Judgment ◽

Conservative Therapy ◽

Coronary Intervention ◽

Artery Dissection ◽

Coronary Artery Dissection ◽

Anterior Myocardial Infarction ◽

Hemodynamic Compromise ◽

Major Coronary Artery ◽

St Elevation

In this report, we describe a case of spontaneous coronary dissection involving left anterior descending artery presenting with acute anterior myocardial infarction successfully treated with thrombolytic and conservative therapy with a suggestion that spontaneous resolution of thrombus occurred before coronary intervention could be performed. As we did not have initial angiogram due to patient’s refusal, this assumption is speculative. However, this case suggests that dissections may heal spontaneously and could be treated with conservative approach in selected cases based on best clinical judgment. It is important to realize that the clinical course of a major coronary artery dissection remains unpredictable. Therefore, cardiologists should always treat each case individually and consider coronary interventions if conservative treatment is not leading to resolution of ST elevation or in patients with hemodynamic compromise. This case is followed by discussion about conservative versus invasive management of spontaneous coronary dissections.

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