A sudden and unexpected death from multiple heart lacerations due to acute myocardial infarction.

ABSTRACT

A sudden and unexpected death due to simultaneous multiple heart lacerations as a result of acute myocardial infarction is very rare and has not been previously described. The authors report a case of 51-year-old woman who died of cardiac tamponade resulting from multiple incomplete left ventricular free wall ruptures due to acute myocardial infarction. At postmortem examination, 250-ml of clotted blood in the pericardial sac was detected. Three lacerations of the left ventricular epicardium and superficial myocardium were also detected. A 1.5-cm linear tear in the anterosuperior region, a 0.7-cm tear in the anteromedial region, and a 0.7-cm tear in the lateral region were visible. At histological examination, massive coagulation necrosis of myocytes and infiltration of polymorphonuclear inflammatory cells in the lacerated areas were found.