Milking-Like Effect as the First Clue of Left Ventricular Free Wall Rupture.

Left ventricular free wall rupture (FWR) is a rare but dreadful complication after acute myocardial infarction (AMI). A coronary "milking-like" effect has been previously related to ventricular pseudoaneurysm or true aneurysm but not yet with other mechanical complications such as left ventricular FWR. We describe 2 patients with AMI showing a coronary milking-like effect in the infarct-related artery at the time of primary percutaneous coronary intervention. Left ventricular FWR eventually developed and the patients died. We propose that a coronary milking-like effect in the infarct-related artery is a marker of patients at high risk for this life-threatening mechanical complication.