Why the study?
Previously published cases of subacute or sealed postinfarction rupture of the free left ventricular wall presented with sudden shock and tamponade, but atypical presentations were not well described.
Case Report (n=1)
This case highlights that subacute left ventricular free wall rupture can present atypically without classic signs of tamponade, and echocardiography is crucial for diagnosis leading to successful surgical intervention.
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Alerts clinicians to atypical subacute LV rupture without tamponade; supports echo-guided diagnosis but leaves open broader applicability.
In previously published cases of subacute or sealed postinfarction rupture of the free left ventricular wall, the patients presented a clinical picture of sudden shock and tamponade. Our patient, a 64-year-old man, suffered renewed chest pain on the fourth postinfarction day and went into cardiogenic shock, which was pharmacologically reversible. There were no bed-side signs of tamponade and the ECG showed the pattern of acute pericarditis, both features in contrast to previously reported cases in the literature. Echocardiography demonstrated localized fluid in the pericardial sac and a puncture revealed non-coagulating blood. The patient was successfully operated on. At surgery a small rupture sealed by blood clots was demonstrated in the infarcted inferior wall of the left ventricle.
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Brodin et al. (1987) conducted a case report in Subacute rupture of the free left ventricular wall following acute myocardial infarction (n=1). Surgical repair was evaluated on Surgical success and survival.
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