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.
Pinto
Nigel
N
Critical Care Research Group, Departments of Cardiology, Cardiac Surgery and Adult Intensive Care, The Prince Charles Hospital, 106 Dunellan Street, Greenslopes, Brisbane, Queensland, Australia.
Platts
David
D
Thomson
Bruce
B
Fraser
John
J
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*