Myocardial free wall rupture as a complication of STEMI

Česká verzia

Authors: Lukáš Urban ^1,2; Milan Dragula ²; Tomáš Bolek ¹; Miloš Kňazeje ²; Matej Samoš ¹
Authors place of work: I. interná klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin ¹; Kardiologické oddelenie, Univerzitná nemocnica Martin ²
Published in the journal: Vnitř Lék 2022; 68(3): 187-190
Category: Case reports

Summary

Myocardial free wall rupture is a rare, but serious complication of acute myocardial infarction with high mortality. We present a case of a 64-year-old patient with this devastating complication of an anterior ST segment elevation myocardial infarction (STEMI) with a prolonged time delay. Cardiac surgery was not performed due to prohibitive surgical risk and predicted poor prognosis. We describe our successful therapeutic intervention consisting of immediate pericardial drainage, vasoactive and inotropic support, intraaortic balloon pump placement and continuous veno-venous hemodialysis. This combined therapy led to patient stabilization and after incremental clinical improvement the patient was able to return to a normal life. After several months a long-term mechanical circulatory support was implanted as a bridge to heart transplant.

Keywords:

myocardial infarction – myocardial free wall rupture – cardiac tamponade

Zdroje

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