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Angiology
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Subacute Cardiac Rupture Complicating Myocardial Infarction

A Case Report

Giuseppe Rosato

Department of Cardiology, Civil Hospital, Avellino, Federico University of Naples

Maurizio Santomauro

Department of Cardiology and Cardiac Surgery, Medical School, Federico University of Naples, Italy

Giovanni Stanco

Department of Cardiology, Civil Hospital, Avellino, Federico University of Naples

Fiorenzo Petillo

Department of Cardiology, Civil Hospital, Avellino, Federico University of Naples

Rosario Sauro

Department of Cardiology, Civil Hospital, Avellino, Federico University of Naples

Massimo Chiariello

Department of Cardiology and Cardiac Surgery, Medical School, Federico University of Naples, Italy

Nicola Spampinato

Department of Cardiology and Cardiac Surgery, Medical School, Federico University of Naples, Italy

Domenico Rotiroti

Department of Cardiology, Civil Hospital, Avellino, Federico University of Naples

The authors have focused this study on the emergence of subacute ventricular free wall rupture in a seventy-six-year-old patient admitted to hospital for inferior acute myocardial infarction. After six days he showed clinical symptoms of bradycardia and hypotension evolving to electromechanical dissociation. Given an adequate pharmacologic therapy, the patient was submitted to echocardiography, which was believed to be consistent with myocardial rupture, showing a moderate to large pericardial effusion. Pericardiocentesis of 150 mL of bloody fluid resulted in a further improvement in his hemodynamics. The patient underwent cardiac surgery with repair of the myocardial rupture through a large diaphragmatic infarction by a Dacron polyester fiber graft and pacemaker placement. In conclusion the authors confirm the relevant role of clinical data such as persistent chest pain and hemodynamic instability and the value of echocardiography in identifying subacute myocardial free wall rupture after an episode of acute myocardial infarction.

Angiology, Vol. 47, No. 2, 189-196 (1996)
DOI: 10.1177/000331979604700211
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