Survival after left ventricular free wall rupture following acute myocardial infarction by conservative treatment

• Published in: The American journal of emergency medicine Vol. 39; pp. 21 - 23
• Main Authors: Yan, Liyuan, Wang, Haipeng, Su, Bo, Fan, Jiali, Wang, Minghan, Zhao, Xin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2021; Elsevier Limited
• Subjects: Acute myocardial infarction; Bedside echocardiography; Blood pressure; Calcium-binding protein; Cardiovascular diseases; Conservative Treatment; Echocardiography; EKG; Electrocardiography; Emergency medical care; Heart; Heart attacks; Heart rate; Heart Rupture, Post-Infarction - diagnostic imaging; Heart Rupture, Post-Infarction - etiology; Heart Rupture, Post-Infarction - therapy; Hemodynamics; Hospitals; Humans; Hypertension; Left ventricular free wall rupture; Male; Medical prognosis; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - diagnostic imaging; Myoglobins; Patients; Pericardiocentesis; Risk factors; Rupture; Survival; Syncope; Treatment Outcome; Troponin; Troponin I; Ventricle; LVFWR; Left ventricular free wall rupture; PPCI; IABP; Pericardiocentesis; STEMI; CAG; Bedside echocardiography; Acute myocardial infarction; AMI
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2020.08.035

Left ventricular free wall rupture (LVFWR) is a rare and fatal mechanical complication following an acute myocardial infarction (AMI). Cases of survival after LVFWR due to ST-segment elevation myocardial infarction (STEMI) treated with a conservative treatment strategy are extremely rare. In this case, a 55-year-old male patient with several cardiovascular risk factors presented to the emergency department with symptoms of ongoing chest pain and syncope. The patient's electrocardiogram was in sinus rhythm with ST-elevation on I, aVL, and V4–6 leads. His myoglobin and troponin I levels were elevated. Due to the unstable hemodynamic state of the patient, bedside echocardiography was performed. The echocardiography indicated LVFWR after AMI. Pericardiocentesis was used to restore a satisfactory hemodynamic state in the patient. Following the initial treatment, the patient opted for a conservative treatment strategy and was uneventfully discharged after 19 days.