Vnitr Lek 2022, 68(3):187-190 | DOI: 10.36290/vnl.2022.037

Myocardial free wall rupture as a complication of STEMI

Lukáš Urban1, 2, Milan Dragula2, Tomáš Bolek1, Miloš Kňazeje2, Matej Samoš1
1 I. interná klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin
2 Kardiologické oddelenie, Univerzitná nemocnica Martin

Myocardial free wall rupture is a rare, but serious complication of acute myocardial infarction with high mortality. We present a case of a 64-year-old patient with this devastating complication of an anterior ST segment elevation myocardial infarction (STEMI) with a prolonged time delay. Cardiac surgery was not performed due to prohibitive surgical risk and predicted poor prognosis. We describe our successful therapeutic intervention consisting of immediate pericardial drainage, vasoactive and inotropic support, intraaortic balloon pump placement and continuous veno-venous hemodialysis. This combined therapy led to patient stabilization and after incremental clinical improvement the patient was able to return to a normal life. After several months a long-term mechanical circulatory support was implanted as a bridge to heart transplant.

Keywords: myocardial infarction, myocardial free wall rupture, cardiac tamponade.

Published: April 26, 2022  Show citation

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Urban L, Dragula M, Bolek T, Kňazeje M, Samoš M. Myocardial free wall rupture as a complication of STEMI. Vnitr Lek. 2022;68(3):187-190. doi: 10.36290/vnl.2022.037.
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    References

    1. Figueras J, Alcalde O, BarrabésJosé A et al. Changes in hospital mortality rates in 425 patients with acute st‑elevation myocardial infarction and cardiac rupture over a 30-year period. Circulation. 2008;118:2783-2789. doi: 10.1161/circulationaha.108.776690. Go to original source... Go to PubMed...
    2. Elbadawi A, Elgendy IY, Mahmoud K et al. Temporal trends and outcomes of mechanical complications in patients with acute myocardial infarction. JACC: Cardiovascular Interventions. 2019;12:1825-1836. doi: 10.1016/j.jcin.2019. 04. 039. Go to original source... Go to PubMed...
    3. Matteucci M, Fina D, Jiritano F, et al. Treatment strategies for post‑infarction left ventricular free‑wall rupture. European Heart Journal: Acute Cardiovascular Care. 2019;8:379-387. doi: 10.1177/2048872619840876. Go to original source... Go to PubMed...
    4. Moreno R, López‑Sendón J, García E et al. Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction. Journal of the American College of Cardiology. 2002;39:598-603. doi: 10.1016/s0735-1097(01)01796-x. Go to original source... Go to PubMed...
    5. Lancellotti P, Price S, Edvardsen T et al. Theuse of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association. European Heart Journal: Acute Cardiovascular Care. 2015;4:3-5. doi: 10.1177/2048872614568073. Go to original source... Go to PubMed...
    6. Reardon MJ, Carr CL, Diamond A et al. Ischemic left ventricular free wall rupture: Prediction, diagnosis, and treatment. The Annals of Thoracic Surgery. 1997;64:1509-1513. doi: 10.1016/s0003-4975(97)00776-5. Go to original source... Go to PubMed...
    7. Leva C. Complete myocardial revascularization and sutureless technique for left ventricular free wall rupture: Clinical and echocardiographic results. Interactive CardioVascular and Thoracic Surgery. 2006;5:408-412. doi: 10.1510/icvts.2006.131037. Go to original source... Go to PubMed...
    8. Blinc A, Noč M, Pohar B et al. Subacute rupture of the left ventricular free wall after acute myocardial infarction. Chest. 1996;109:565-567. doi: 10.1378/chest.109. 2. 565. Go to original source... Go to PubMed...
    9. Formica F, D'Alessandro S, Singh G, et al. Left ventricular free wall rupture after myocardial infarction: Still a challenging complication. The Journal of Thoracic and Cardiovascular Surgery. 2019. doi: 10.1016/j.jtcvs.2019. 05. 038. Go to original source...
    10. Khalid N, Rogers T, Shlofmitz E et al. Adverse events and modes of failure related to the impella percutaneous left ventricular assist devices: A retrospective analysis of the maude database. EuroIntervention. 2019;15:44-46. doi: 10.4244/eij‑d-18-01021. Go to original source... Go to PubMed...
    11. Ghionzoli N, Sciaccaluga C, Mandoli GE, et al. Cardiogenic shock and acute kidney injury: The rule rather than the exception. Heart Failure Reviews. 2020;26:487-496. doi: 10.1007/s10741-020-10034-0. Go to original source... Go to PubMed...
    12. McDonagh TA, Metra M, Adamo M et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2021;42:3599-3726. doi: 10.1093/eurheartj/ehab368. Go to original source... Go to PubMed...
    13. Frances C, Romero A, Grady D, et al. Left ventricular pseudoaneurysm. Journal of the American College of Cardiology. 1998;32:557-561. doi: 10.1016/s0735-1097(98)00290-3. Go to original source... Go to PubMed...

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