This case highlights an unusual presentation of left ventricular free wall rupture following acute MI in the setting of severe systolic dysfunction and cardiac amyloidosis.
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May raise rupture risk post-MI in cardiac amyloidosis; leaves open causal association requiring larger studies.
A 74-year-old man died of left ventricular free wall rupture 6 days following an acute inferoposterior wall myocardial infarction. His hospital course was complicated by pump failure which proved resistant to inotropic support, diuresis, and percutaneous transluminal coronary angioplasty. At necropsy, extensive amyloid deposition was noted. This case constitutes an unusual clinical setting for myocardial rupture because of the severity of systolic left ventricular dysfunction as well as cardiac amyloidosis.
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Shirani et al. (1990) studied this question.
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