Qayoom Reema, Amin Muhammad Adnan, Akhter Junaid
Department of Cardiology, Tabba Heart Institute, Karachi, Pakistan.
Department of Cardiology, Tabba Heart Institute, Karachi.
J Pak Med Assoc. 2020 Sep;70(9):1653-1654. doi: 10.5455/JPMA.51034.
Ventricular free wall rupture is a rare complication of acute myocardial infarction (MI) i.e. <1.7% of cases, although it occurs more frequently than might be expected. Without imaging evidence or autopsy, sudden cardiac death in acute MI setting is commonly attributed to fatal dysrhythmias, high degree atrio-ventricular blocks or pulmonary embolism resulting in underdiagnosis of free wall rupture. Modern therapies have probably reduced the incidence but not eliminated the problem. We present a case of left ventricular free wall rupture in acute MI setting and syncopal presentation. The diagnosis was established during left heart catheterisation and further confirmed on transthoracic echocardiography. The patient deteriorated abruptly, pericardial window was made to bridge for surgical repair. Unfortunately, the patient died before surgical intervention.
心室游离壁破裂是急性心肌梗死（MI）的一种罕见并发症，即发生率<1.7%，尽管其发生频率比预期的更高。在没有影像学证据或尸检的情况下，急性心肌梗死患者的心脏性猝死通常归因于致命性心律失常、高度房室传导阻滞或肺栓塞，从而导致游离壁破裂的诊断不足。现代治疗方法可能降低了其发生率，但并未消除这一问题。我们报告一例急性心肌梗死合并晕厥表现的左心室游离壁破裂病例。诊断在左心导管检查时确立，并经经胸超声心动图进一步证实。患者病情突然恶化，进行了心包开窗术以过渡到手术修复。不幸的是，患者在手术干预前死亡。
