Résumé
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.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Procédures de chirurgie cardiovasculaire/méthodes , Rupture du coeur post-infarctus/chirurgie , Infarctus du myocarde/chirurgie , Rupture du coeur post-infarctus/imagerie diagnostique , Échocardiographie , Techniques de suture , Coronarographie , Ventricules cardiaques/chirurgie , Infarctus du myocarde/physiopathologie , Infarctus du myocarde/imagerie diagnostiqueSujets)
Humains , Mâle , Sujet âgé , Muscles papillaires/imagerie diagnostique , Thrombose/complications , Bioprothèse/effets indésirables , Rupture du coeur post-infarctus/étiologie , Prothèse valvulaire cardiaque/effets indésirables , Thrombose/imagerie diagnostique , Rupture du coeur post-infarctus/imagerie diagnostique , Défaillance de prothèse/effets indésirables , Échocardiographie transoesophagienne , Insuffisance mitrale/chirurgieRésumé
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.