[Acute rupture of the left ventricle 12 hours after an anteroseptal myocardial infarct. Successful surgical repair].
Acute rupture of the left ventricular free wall was suspected in a 53 year old hypertensive patient at the 12th hour of primary antero-septo-apical myocardial infarction. He developed acute tamponade with severe cardiogenic shock during his transfer to hospital. Cardiac compression due to hemopericardium was confirmed by M mode echocardiography (pericardial effusion), right heart catheterisation (adiastole and low cardiac output) and pericardial puncture during which several ccs of blood were aspirated leading to a slight improvement in the patient's condition. At operation under cardiopulmonary bypass 2,5 hours after hospital admission, the surgeon found a hemopericardium related to fissuration of an acute apical infarct which was sutured on a Teflon support. The initial postoperative course was complicated by unexplained gastro-intestinal hemorrhage, transient functional renal failure, cardiac failure and mediastinitis, but the final outcome was successful with a follow-up of 24 months. This appears to be the 9th reported case of long-term survival after surgical repair of rupture of the heart in the acute phase of myocardial infarction.
D004562:Electrocardiography; D004630:Emergencies; D006341:Heart Rupture / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors
Rupture aiguë du ventricule gauche à la 12e heure d'un infarctus du myocarde antéro-septal. Réparation chirurgicale avec succès.