Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report
Abstract Background There are three major mechanical complications after acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication following an ST...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-019-1063-x |
| _version_ | 1819028741373820928 |
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| author | Dulman O. Pineda-De Paz Jorge E. Hernández-del Rio Christian González-Padilla Ramón M. Esturau-Santaló Joseph Romero-Palafox Fernando Grover-Paez David Cardona-Muller |
| author_facet | Dulman O. Pineda-De Paz Jorge E. Hernández-del Rio Christian González-Padilla Ramón M. Esturau-Santaló Joseph Romero-Palafox Fernando Grover-Paez David Cardona-Muller |
| author_sort | Dulman O. Pineda-De Paz |
| collection | DOAJ |
| description | Abstract Background There are three major mechanical complications after acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication following an ST elevation myocardial infarction. However, very rarely this rupture can be contained by the pericardium, forming a pseudoaneurysm. Case presentation We report a case of a 66-year-old man with multiple cardiovascular risk factors and previous ST elevation myocardial infarction, complaining of atypical chest pain. His electrocardiogram was in normal sinus rhythm, with the presence of Q wave in inferior leads and T-wave inversion in lateral leads. A transthoracic echocardiogram showed a left ventricular pseudoaneurysm. In the coronary angiography, multi-vessel disease was found. On-pump CABG was performed and a posterolateral left ventricular giant pseudoaneurysm were observed. Due its “petrous” consistency it was impossible to perform an aneurysmectomy. Conclusions The diagnosis of left ventricular pseudoaneurysm can be difficult, as patients often present either asymptomatic or with non-specific symptoms attributed to other causes. A multimodality imaging diagnostic approach can be necessary. Immediate surgery is considered the treatment of choice because untreated pseudoaneurysms have a high risk of rupture leading to cardiac tamponade, shock and death. |
| first_indexed | 2024-12-21T06:03:11Z |
| format | Article |
| id | doaj.art-41afa616db1346ab97f74c6c4b4238a8 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-21T06:03:11Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-41afa616db1346ab97f74c6c4b4238a82022-12-21T19:13:43ZengBMCBMC Cardiovascular Disorders1471-22612019-04-011911710.1186/s12872-019-1063-xLeft ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case reportDulman O. Pineda-De Paz0Jorge E. Hernández-del Rio1Christian González-Padilla2Ramón M. Esturau-Santaló3Joseph Romero-Palafox4Fernando Grover-Paez5David Cardona-Muller6Departamento de Cardiología, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartamento de Cardiología, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartamento de Cardiología, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartamento de Cardiología, Antiguo Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraCentro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraAbstract Background There are three major mechanical complications after acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication following an ST elevation myocardial infarction. However, very rarely this rupture can be contained by the pericardium, forming a pseudoaneurysm. Case presentation We report a case of a 66-year-old man with multiple cardiovascular risk factors and previous ST elevation myocardial infarction, complaining of atypical chest pain. His electrocardiogram was in normal sinus rhythm, with the presence of Q wave in inferior leads and T-wave inversion in lateral leads. A transthoracic echocardiogram showed a left ventricular pseudoaneurysm. In the coronary angiography, multi-vessel disease was found. On-pump CABG was performed and a posterolateral left ventricular giant pseudoaneurysm were observed. Due its “petrous” consistency it was impossible to perform an aneurysmectomy. Conclusions The diagnosis of left ventricular pseudoaneurysm can be difficult, as patients often present either asymptomatic or with non-specific symptoms attributed to other causes. A multimodality imaging diagnostic approach can be necessary. Immediate surgery is considered the treatment of choice because untreated pseudoaneurysms have a high risk of rupture leading to cardiac tamponade, shock and death.http://link.springer.com/article/10.1186/s12872-019-1063-xLeft ventriclePseudoaneurysmMyocardial infarctionCase report |
| spellingShingle | Dulman O. Pineda-De Paz Jorge E. Hernández-del Rio Christian González-Padilla Ramón M. Esturau-Santaló Joseph Romero-Palafox Fernando Grover-Paez David Cardona-Muller Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report BMC Cardiovascular Disorders Left ventricle Pseudoaneurysm Myocardial infarction Case report |
| title | Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report |
| title_full | Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report |
| title_fullStr | Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report |
| title_full_unstemmed | Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report |
| title_short | Left ventricular free-wall rupture, a potentially lethal mechanical complication of acute myocardial infarction: an unusual and illustrative case report |
| title_sort | left ventricular free wall rupture a potentially lethal mechanical complication of acute myocardial infarction an unusual and illustrative case report |
| topic | Left ventricle Pseudoaneurysm Myocardial infarction Case report |
| url | http://link.springer.com/article/10.1186/s12872-019-1063-x |
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