title: Conservative Treatment of Left Ventricular Free Wall Rupture.
abstract: We present a case of post-infarction Left Ventricular Free Wall Rupture (LVFWR), in which conservative treatment was successfully applied. A 48-year old male patient presented at our emergency department with abdominal pain and a clinical presentation of shock. There had been an episode of chest pain three days before admission. Electrocardiogram was suggestive for old myocardial infarction. Coronarography revealed an occlusion of a diagonal branch. Computed Tomography scan was performed to exclude a rupturing aortic aneurysm, but a large pericardial effusion was seen. Echocardiography confirmed the diagnosis of cardiac tamponade and pericardiocentesis was performed. Conservative treatment consisting of bed rest, blood pressure control and beta-blocker therapy was applied, allowing the patient to be discharged after 10 days. The diagnosis of LVFWR was confirmed by cardiac magnetic resonance imaging.Surgery is considered as the golden standard in treatment of LVFWR. This case illustrates that in selected patients conservative treatment is possible.
authors.affiliation: Department of General Surgery, AZ Maria Middelares, Ghent, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Dewulf
authors.forename: K
authors.initials: K
authors.lastname: Cathenis
authors.forename: D
authors.initials: D
authors.lastname: Goossens
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001510:Bed Rest; D006341:Heart Rupture / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents