Memon Waqas, Aamir Muhammed, Memon Areeka, Mikhail Maha
Internal Medicine/Nephrology, Virginia Commonwealth University, Richmond, USA.
Internal Medicine, Carle Foundation Hospital, Urbana, USA.
Cureus. 2020 Jun 6;12(6):e8470. doi: 10.7759/cureus.8470.
Myocardial rupture is a rare complication of acute myocardial infarction (MI), usually presenting with chest pain. The most common site of rupture is the anterior wall. Myocardial rupture presents similar to cardiac tamponade, most frequently as cardiogenic shock. Many clinical conditions, however, present similarly. The differential diagnosis should include myocardial rupture if clinical suspicion is high. This report describes a 77-year-old man with a medical history putting him at significant risk for coronary artery disease status, including a coronary artery bypass graft, chronic kidney disease stage 3, and hyperlipidemia. He presented at the ED for worsening shortness of breath and feeling unwell. Transthoracic echocardiography revealed an anterior, anterolateral akinesis, a ventricular septal defect, and free wall rupture. Myocardial rupture is an acute cardiac emergency; a high level of clinical suspicion may help in detecting this rare manifestation of acute MI.
心肌破裂是急性心肌梗死（MI）的一种罕见并发症，通常表现为胸痛。最常见的破裂部位是前壁。心肌破裂的表现类似于心脏压塞，最常见的是心源性休克。然而，许多临床情况也有类似表现。如果临床怀疑度高，鉴别诊断应包括心肌破裂。本报告描述了一名77岁男性，其病史使其患冠状动脉疾病的风险显著增加，包括冠状动脉旁路移植术、慢性肾脏病3期和高脂血症。他因呼吸急促加重和感觉不适而到急诊科就诊。经胸超声心动图显示前壁、前侧壁运动减弱、室间隔缺损和游离壁破裂。心肌破裂是一种急性心脏急症；高度的临床怀疑可能有助于检测急性心肌梗死的这种罕见表现。
