RESUMO
Pseudoaneursym (PA) formation of left ventricle (LV) following acute myocardial infarction (AMI) is uncommon and is usually believed to be associated with a grave prognosis. We describe a case of 55 year old male patient presented with AMI and heart failure with a systolic murmur later diagnosed to have PA of the lateral wall of LV on echocardiography (transthoracic and transesophageal, TTE andTEE). Cardiac MRI and coronary angiogram (CAG) were performed. CAG showed 60% lesion at origin of major obtuse marginal artery (OM1). The patientwas advised surgical treatment, but he refused and took discharge against medical advice on 27th dayof admission on stable condition.
Assuntos
Falso Aneurisma/diagnóstico , Ecocardiografia Transesofagiana/métodos , Eletrocardiografia/métodos , Aneurisma Cardíaco/diagnóstico , Ruptura Cardíaca Pós-Infarto/diagnóstico , Humanos , Índia , Angiografia por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Medição de Risco , Índice de Gravidade de Doença , Recusa do Paciente ao TratamentoRESUMO
Ventricular rupture following myocardial infarction is a serious clinical problem with a high mortality. A 60-year-old man with left ventricular rupture and cardiac tamponade following myocardial infarction was managed successfully by emergency surgery. An onlay patch of Teflon held in place by an adhesive without any sutures was used to repair the ruptured myocardium.
Assuntos
Estimulação Cardíaca Artificial , Procedimentos Cirúrgicos Cardíacos , Tamponamento Cardíaco/diagnóstico , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Ecocardiografia , Ruptura Cardíaca Pós-Infarto/diagnóstico , Ventrículos do Coração/lesões , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Técnicas de SuturaRESUMO
Left ventricular rupture is a fatal complication of acute myocardial infarction, however accurate preoperative diagnosis is still difficult. We experienced a postinfarction left ventricular rupture patient whose symptoms and radiologic findings mimicked those of acute intramural hematoma of the aorta. Upon emergency operation, he was proven to have a postinfarction LV rupture and underwent successful surgery. We herein report the case with a brief review of the literature.
Assuntos
Humanos , Masculino , Doenças da Aorta/diagnóstico , Erros de Diagnóstico , Ruptura Cardíaca Pós-Infarto/diagnóstico , Hematoma/diagnóstico , Pessoa de Meia-IdadeAssuntos
Humanos , Protocolos Clínicos , Infarto do Miocárdio/complicações , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/terapia , Angina Pectoris/tratamento farmacológico , Angina Pectoris/etiologia , Arritmias Cardíacas/tratamento farmacológico , Arritmias Cardíacas/terapia , Bloqueio Cardíaco/tratamento farmacológico , Comunicação Interventricular/diagnóstico , Pericardite/tratamento farmacológico , Ruptura Cardíaca Pós-Infarto/diagnóstico , Complexos Ventriculares Prematuros/tratamento farmacológicoRESUMO
Eight cases of ruptured interventricular septum associated with myocardial infarction were diagnosed at Siriraj Hospital between 1985-1995. Clinical congestive heart failure and holosystolic murmur were found in all. Diagnosis was confirmed by echocardiogram and right heart catheterization in all patients. Two patients died from congestive heart failure preoperatively and the third case died from organ failure and sepsis postoperatively. Another five cases underwent successful ventricular septal defect closure and coronary artery bypass with good results.
Assuntos
Idoso , Ponte de Artéria Coronária , Ecocardiografia , Eletrocardiografia , Feminino , Cateterismo Cardíaco , Ruptura Cardíaca Pós-Infarto/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura do Septo Ventricular/diagnósticoRESUMO
We present three patients with left ventricular free wall rupture post acute myocardial infarction, all three treated successfully through surgery. Two of them were submitted to streptokinase IV. In all cases the diagnosis were based on clinical and echocardiographic features. The authors conclude that the diagnostic suspicion can be done easily, the echocardiogram is very useful, and the surgical treatment may led to a good short- and long-term survival