A Lethal But Treatable Complication: Free Wall Rupture After Acute Myocardial Infarction
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Mehmet S. Ülgen 1 * , Önder Öztürk 2, Mehmet Kayrak 1, Ahmet Soylu 1, M. Akif Düzenli 1, Fatih Koç 1
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1 Selçuk University, Meram Medical Faculty, Department of Cardiology, Konya, Turkey
2 Dicle University, Medical Faculty, Department of Cardiology, Diyarbakır, Turkey
* Corresponding Author

Abstract

A 43-year-old male patient was admitted to coronary intensive care unit with the diagnosis of acute inferolateral myocardial infarction and with a picture of cardiogenic shock. In physical examination, systolic blood pressure was 50 mmHg and diastolic blood pressure could not be taken. The patient was diagnosed with cardiogenic shock and was started on saline, dopamine and dobutamine infusion. His blood pressure did not increase although the dosage of positive inotropic agents was increased. A cardiac tamponade revealed with urgent echocardiographic evaluation and pericardiocentesis was carried out. Blood pressure returned to normal range within hours after pericardiosentesis. Echocardiographic examination performed on the second day of AMI on the asymptomatic patient revealed thrombosed myocardial rupture. The patient was referred to emergency surgery with the diagnosis of three-vessel disease and myocardial rupture according to urgent angiography. In the operation, the ruptured region in the ventricle free wall was primarily repaired. By-pass surgery was performed with saphenous vein graft to the LAD and CV-OM1 coronary arteries.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

https://doi.org/10.29333/ejgm/82364

EUR J GEN MED, 2006 - Volume 3 Issue 1, pp. 41-44

Publication date: 15 Jan 2006

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