An unexpected electrocardiogram sign of subacute left ventricular free wall rupture: Its early awareness may be lifesaving
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Key result
New ST elevation with recurrent chest pain and hypotension may signal impending subacute LVFWR.
- n=2
Why the study?
Post-infarct left ventricular free wall rupture can be subacute, allowing time for diagnosis and intervention, but early recognition is critical and may be lifesaving.
Comparison
Not applicable, case series describing ECG changes in subacute LVFWR
Design
Case report
Authors
Discussion
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Member takes
Implication
May prompt urgent evaluation for subacute LV rupture in post-MI patients; hypothesis-generating case observation requiring prospective validation.
Study Design
Type
Case Report (n=2)
Multicenter
No
Structured PICO
P
Population
Two women in their 80s with anterior ST-segment elevation myocardial infarction who developed subacute left ventricular free wall rupture.
O
Outcome
Diagnosis of subacute left ventricular free wall rupture (LVFWR)
New ST-segment re-elevation in infarct-related leads accompanied by recurrent chest pain and hypotension should raise immediate suspicion for subacute left ventricular free wall rupture rather than reinfarction.
Limitations
- Clinical presentation lacks specificity
- ECG sign may be sometimes deceptive
- Low incidence makes it likely to be erroneously attributed to ischemia
Cite This Study
Wu et al. (2020) conducted a case report in Subacute left ventricular free wall rupture (n=2). New ST-segment elevation in infarct-associated leads was evaluated on Diagnosis of subacute left ventricular free wall rupture. New ST-segment elevation in infarct-associated leads, coupled with recurrence of chest pain and new-onset hypotension, may constitute premonitory signs of a subacute left ventricular free wall rupture.
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