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Background <p>The frequency of mechanical complications related to transmural myocardial infarction (MI) has decreased due to the widespread implementation of reperfusion therapies. However, mortality related to these complications remains high, requiring prompt intervention by a Heart Team. Ventricular double rupture (VDR) is a particularly rare and fatal MI complication.</p> Case presentation <p>A 58-year-old female patient presenting with 3 days of chest pain was diagnosed with ST-elevation MI. She underwent primary percutaneous coronary intervention of the left anterior descending artery. Transthoracic echocardiogram revealed an apical ventricular septum rupture and a mild pericardial effusion suggestive of free wall rupture. Emergent surgical repair included ventricular septal defect closure with a heterologous pericardial patch and repair of the free wall rupture with Dacron patch placement. Perioperative intraaortic balloon pump support was utilized. The patient had a favorable clinical course and was asymptomatic at her cardiology follow-up.</p> Conclusions <p>VDR is the combination of two types of mechanical complications of MI. High clinical suspicion is necessary in hemodynamically unstable patients and those with risk factors for myocardial rupture, warranting echocardiographic evaluation for its diagnosis and characterization. Treatment of VDR is primarily surgical and may involve mechanical circulatory support (MCS). Despite advances in reperfusion therapies and surgical techniques, the prognosis of VDR remains poor. Our patient had a favorable outcome highlighting the importance of a multidisciplinary approach.</p>

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Ventricular double rupture following myocardial infarction: a case report and literature review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月18日

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  • Camilo Andres Calderon-Miranda,
  • Carlos Enrique Vesga-Reyes,
  • Pastor Olaya,
  • Maria Juliana Reyes-Cardona,
  • Jairo Sanchez-Blanco,
  • Jorge Alexander Zambrano-Franco,
  • Gustavo Adolfo Cruz-Suarez,
  • Alvaro Diego Peña-Gonzalez

摘要

Background

The frequency of mechanical complications related to transmural myocardial infarction (MI) has decreased due to the widespread implementation of reperfusion therapies. However, mortality related to these complications remains high, requiring prompt intervention by a Heart Team. Ventricular double rupture (VDR) is a particularly rare and fatal MI complication.

Case presentation

A 58-year-old female patient presenting with 3 days of chest pain was diagnosed with ST-elevation MI. She underwent primary percutaneous coronary intervention of the left anterior descending artery. Transthoracic echocardiogram revealed an apical ventricular septum rupture and a mild pericardial effusion suggestive of free wall rupture. Emergent surgical repair included ventricular septal defect closure with a heterologous pericardial patch and repair of the free wall rupture with Dacron patch placement. Perioperative intraaortic balloon pump support was utilized. The patient had a favorable clinical course and was asymptomatic at her cardiology follow-up.

Conclusions

VDR is the combination of two types of mechanical complications of MI. High clinical suspicion is necessary in hemodynamically unstable patients and those with risk factors for myocardial rupture, warranting echocardiographic evaluation for its diagnosis and characterization. Treatment of VDR is primarily surgical and may involve mechanical circulatory support (MCS). Despite advances in reperfusion therapies and surgical techniques, the prognosis of VDR remains poor. Our patient had a favorable outcome highlighting the importance of a multidisciplinary approach.