Presentation with pulsatile xiphisternal bruise-Survival with a chronic ventricular rupture.
Ventricular free wall rupture is an acute, severe complication of myocardial infarction (MI). Accounting for 20-30% of MI mortality, ventricular rupture is fatal if not detected early and repaired surgically. The unique case of a delayed, chronic rupture is reported in a 64 year-old male who presented with a painless, pulsatile, sub-xiphisternal bruise, five years post MI. Trans-thoracic echocardiography (TTE) revealed haematoma extending posteriorly with only contrast echocardiography revealing an active communication between the sub-dermal area and the heart. Urgent surgery and a prolonged period in ICU enabled sufficient enough recovery for discharge.
Critical Care Research Group, Departments of Cardiology, Cardiac Surgery and Adult Intensive Care, The Prince Charles Hospital, 106 Dunellan Street, Greenslopes, Brisbane, Queensland, Australia.
Nigel
N
Pinto
David
D
Platts
Bruce
B
Thomson
John
J
Fraser
D002908:Chronic Disease; D003288:Contusions / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D004452:Echocardiography; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*