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  • Non-ST-segment elevation myocardial infarction with evidence of transmural infarction complicated by left ventricular rupture during percutaneous coronary intervention

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Reminder of important clinical lesson
Case report
Non-ST-segment elevation myocardial infarction with evidence of transmural infarction complicated by left ventricular rupture during percutaneous coronary intervention
  1. Niall PE Connolly1,
  2. Breda Hennessey2 and
  3. Darren Mylotte1
  1. 1Cardiology, Galway University Hospital, Galway, Ireland
  2. 2San Carlos University Hospital Cardiovascular Institute, Madrid, Comunidad de Madrid, Spain
  1. Correspondence to Dr Niall PE Connolly; niallcon{at}gmail.com

Abstract

We report a case of a 68-year-old man presenting with a non-ST-segment elevation myocardial infarction, complicated by fatal left ventricular free wall rupture with electromechanical disassociation and cardiac tamponade during percutaneous coronary intervention. The aetiology for the sudden haemodynamic collapse was initially unclear; however, transthoracic echocardiography confirmed pericardial tamponade and postmortem revealed complete transmural myocardial infarction with left ventricular free wall rupture. This serves as an important lesson that transmural infarction and subsequent mechanical complications, including ventricular rupture, can occur in non-ST-segment myocardial infarction and not just ST-segment myocardial infarction.

  • ischaemic heart disease
  • interventional cardiology
  • cardiovascular medicine
  • interventional cardiology

https://doi.org/10.1136/bcr-2020-235459

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    Footnotes

    • Contributors NPEC researched, wrote, edited and revised the manuscript. BH researched and drafted the outline of the case. DM revised and edited the manuscript and performed the coronary angioplasty.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer-reviewed.