This case report describes the rare autopsy findings of incomplete left atrial rupture following left atrial infarction associated with left ventricular myocardial infarction due to left circumflex artery occlusion.
Alerts clinicians to rare left atrial rupture in LCx infarction; leaves open questions on incidence and early detection.
We report a 78-year-old woman with incomplete left atrial rupture following left atrial infarction associated with left ventricular myocardial infarction. An autopsy revealed a hemopericardium. A large hematoma was observed in the posterior wall of the left atrium and a few small tears were found on the same wall. Near its origin, the left circumflex artery was severely sclerotic and completely occluded by fresh thrombus. Histologic examination revealed that large intramural hematoma longitudinally dissected the inner third of the posterior wall of the left atrium, and transversely dissected through the necrotic tissue to the pericardial sac to result in rupture. Coagulation necrosis and intramyocardial hemorrhage were also observed throughout the entire left atrium and the postseptolateral wall of the left ventricle.
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Chida et al. (1995) studied this question.
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