Successful Healing of the Myocardial Rupture Complicated by the Occlusion of a Single Diagonal Branch / 대한내과학회지

ABSTRACT

Myocardial rupture is a rare but lethal complication of myocardial infarction. Immediate conservative management is critical, but surgery should be considered if the patient's hemodynamic state and degree of hemopericardium do not improve after pericardiocentesis. In this case, a 54-year old patient without underlying disease came to the emergency after experiencing chest pain for two weeks with suddenly aggravated severe dyspnea. The patient was found to have a hemopericardium with cardiac tamponade, so pericardiocentesis was immediately executed. Transthoracic echocardiogram revealed akinesia of the left ventricular muscle and focal wall thinning. The patient was diagnosed with complete occlusion of a single diagonal branch and ventricular free wall rupture using a coronary computed tomography scan. After conservative treatment, vital signs and cardiac function stabilized, and there was no definitive sequela. This case is clinically significant because myocardial rupture, a lethal complication of myocardial infarction, was successfully managed with non-surgical, conservative treatment.