SUBACUTE CARDIAC RUPTURE COMPLICATING MYOCARDIAL-INFARCTION - A CASE-REPORT

The authors have focused this study on the emergence of subacute ventr icular free wall rupture in a seventy-six-year-old patient admitted to hospital for inferior acute myocardial infarction. After six days he showed clinical symptoms of bradycardia and hypotension evolving to el ectromechanical dissociation. Given an adequate pharmacologic therapy, the patient was submitted to echocardiography, which was believed to be consistent with myocardial rupture, showing a moderate to large per icardial effusion. Pericardiocentesis of 150 mL of bloody fluid result ed in a further improvement in his hemodynamics. The patient underwent cardiac surgery with repair of the myocardial rupture through a large diaphragmatic infarction by a Dacron polyester fiber graft and pacema ker placement. In conclusion the authors confirm the relevant role of clinical data such as persistent chest pain and hemodynamic instabilit y and the value of echocardiography in identifying subacute myocardial free wall rupture after an episode of acute myocardial infarction.