ABSTRACT
Abstract Ventricular free wall rupture is a fatal mechanical complication of acute myocardial infarction. In some cases it can be represented as subacute clinic and may not cause death in a few minutes. Acute pseudo-aneurysms are extremely unstable and bound to fatal rupture. Herein we report a male patient who suffered dyspnea and mild chest pain, 4 weeks after acute ST-segment elevation myocardial infarction.
Subject(s)
Humans , Male , Middle Aged , Cardiovascular Surgical Procedures/methods , Heart Rupture, Post-Infarction/surgery , Myocardial Infarction/surgery , Heart Rupture, Post-Infarction/diagnostic imaging , Echocardiography , Suture Techniques , Coronary Angiography , Heart Ventricles/surgery , Myocardial Infarction/physiopathology , Myocardial Infarction/diagnostic imagingSubject(s)
Humans , Male , Aged , Papillary Muscles/diagnostic imaging , Thrombosis/complications , Bioprosthesis/adverse effects , Heart Rupture, Post-Infarction/etiology , Heart Valve Prosthesis/adverse effects , Thrombosis/diagnostic imaging , Heart Rupture, Post-Infarction/diagnostic imaging , Prosthesis Failure/adverse effects , Echocardiography, Transesophageal , Mitral Valve Insufficiency/surgeryABSTRACT
Transesophageal echocardiography was performed to evaluate the exact cause of severe mitral regurgitation in a 64-year-old man presented with hypotension and dyspnea after acute inferior wall myocardial infarction. In mid-esophageal two-and four-chamber view, the ruptured stump of papillary muscle could not be visualized. However, in transgastric two-chamber view, we could clearly visualize the ruptured head of the posteromedial papillary muscle as a separated mass attached by chorda tendinae, as well as the freely mobile stump of the ruptured papillary muscle within the left ventricle. So, the comprehensive transesophageal echocardiography, including transgastric imaging, is always indicated in patients with severe mitral regurgitation after acute myocardial infarction.