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07 August 2019 : Case report  Japan

Fatal Right Ventricular Free Wall Rupture During Percutaneous Coronary Intervention for Inferior Acute Myocardial Infarction

Rare disease

Daisuke Ueno1ABCDE*, Tetsuya Nomura1AEF, Kenshi Ono1F, Yu Sakaue1F, Yusuke Hori1F, Kenichi Yoshioka1F, Masakazu Kikai1AF, Natsuya Keira1AF, Tetsuya Tatsumi1DG

DOI: 10.12659/AJCR.917217

Am J Case Rep 2019; 20:1155-1158

Abstract

BACKGROUND: Ventricular rupture is a complication of acute myocardial infarction (AMI) that results in hemopericardium and cardiac tamponade and has a high mortality rate. Most cases involve the left ventricular free wall, and there have been few previous reports of solitary right ventricular free wall rupture. This report is of a case of fatal right ventricular free wall rupture during percutaneous coronary intervention (PCI) for inferior acute myocardial infarction (AMI).

CASE REPORT: A 76-year-old woman underwent emergency coronary angiography following inferior AMI. During angiography and attempted percutaneous coronary intervention (PCI), sudden onset of cardiac arrest occurred due to cardiac tamponade. Blood was drained from the pericardium by pericardiocentesis. Despite of advanced cardiac support, the patient died. The post mortem findings showed a solitary right ventricular free wall rupture due to inferior myocardial infarction.

CONCLUSIONS: A rare case is presented of right ventricular free wall rupture following AMI that occurred during PCI. This case demonstrates that early diagnosis and management are required to prevent patient mortality.

Keywords: Cardiovascular Diseases, case reports, Heart Rupture, Myocardial Infarction, Aged, Cardiac Tamponade, Fatal Outcome, Heart Rupture, Post-Infarction, Heart Ventricles, Inferior Wall Myocardial Infarction, percutaneous coronary intervention

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923