SUBACUTE VENTRICULAR FREE-WALL RUPTURE PRESENTING AS TAMPONADE WITHOUT FRANK HEMOPERICARDIUM

Ventricular free-wall rupture is a well-known catastrophic complicatio n of acute myocardial infarction. A significant number of patients pre sent in a subacute fashion and can be successfully treated with surger y if diagnosed promptly. We present a case of subacute free-wall ruptu re that occurred after an undiagnosed myocardial infarction. The findi ngs at pericardiocentesis were unusual in that the fluid was sanguinou s but not frank hemopericardium. This patient represents the first kno wn reported case to present without frank hemopericardium who survived and was successfully treated surgically, The absence of frank hemoper icardium should not exclude the diagnosis of free-wall rupture. (C) 19 98 Wiley-Liss, Inc.