[Survivor of blow out type of free wall rupture: multislice computed tomographic detection of myocardial rupture in a case of small myocardial infarction].

A 73-year-old man was admitted to the emergency room because of shock and loss of consciousness. Electrocardiography and echocardiography revealed myocardial infarction of the inferoposterior wall and cardiac tamponade. However, laboratory data showed mild inflammation without elevation of any cardiac enzymes. Under percutaneous cardiopulmonary support, coronary angiography showed stenosis of only a small posterior descending branch of the right coronary artery. Multislice computed tomography provided a definite diagnosis of free wall rupture of the left ventricle, clearly showing the tear of the inferior wall. After surgical repair and rehabilitation, he returned to a normal life. Small inferior wall infarction rarely causes the blow out type of left ventricular free wall rupture. Multislice computed tomography is a fast and noninvasive tool for the detection of ventricular rupture as well as acute dissection of ascending aorta, both of which may result in cardiac tamponade and may not be visualized by echocardiography.