eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2020
vol. 17
 
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abstract:
Letter to the Editor

Incomplete myocardial rupture following inferolateral myocardial infarction

Maciej Kabaj
1
,
Mikołaj Berezowski
2
,
Roman Przybylski
3
,
Agnieszka Witkowska
4
,
Tomasz Brzostowicz
5
,
Wojciech Kosmala
1

  1. Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland
  2. Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
  3. Department of Heart Transplantation and Mechanical Circulatory Support, Wroclaw Medical University, Wroclaw, Poland
  4. Centre for Heart Diseases, University Hospital, Wroclaw, Poland
  5. RADOMED – CMR Unit, Nysa, Poland
Kardiochir Torakochir Pol 2020; 17 (2): 105-106
DOI: https://doi.org/10.5114/kitp.2020.97271
Online publish date: 2020/07/20
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A 35-year-old man with no significant past medical history was admitted to the cardiology department with inferolateral ST-elevation myocardial infarction. Coronary angiogram performed immediately after admission (approximately 11–12 hours after the onset of chest pain) revealed right coronary artery occlusion, which was successfully revascularized by percutaneous coronary intervention (PCI) with drug-eluting stent implantation. Postprocedural transthoracic echocardiography showed left ventricular (LV) function abnormalities with ejection fraction reduced to 38%, akinesis of inferior, inferolateral and lateral segments, as well as an aneurysmatic bulge in the inferolateral wall, with wall thickness decreased to 3–4 mm. No pericardial effusion or evidence of cardiac tamponade were found. In view of these findings, urgent cardiac magnetic resonance (CMR) imaging was performed to further explore the morphology of LV wall thinning. This examination revealed incomplete free wall rupture (FWR) encompassing mid inferior, inferolateral and lateral segments (Figures 1 A, B).
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