title: Sudden death due to ventricular double rupture as a complication of inferior acute myocardial infarction: A case report.
abstract: BACKGROUND
  Ventricular double rupture (VDR) is a rare but lethal mechanical complication of acute myocardial infarction (AMI). The early identification and timely treatment of VDR remain challenging problems. We present a case of AMI with VDR and briefly review the characteristics and prognosis of this life-threatening disease.
  
  
  METHODS
  A 77-year-old male presented to our hospital with a 4-day history of severe dizziness, mild chest tightness, and dyspnea. An inferior AMI was diagnosed.
  
  
  RESULTS
  On the second hospital day, hypotension and a new cardiac murmur was found. The emergency echocardiographic study disclosed a ventricular septal defect. Soon after that the patient suddenly died of ventricular free-wall rupture.
  
  
  CONCLUSIONS
  In patients with AMI complicated by a septal perforation in the apical region, close to the septum-free wall junction, special attention should be paid to the great risk of VDR. Other high risk factors included advanced age, delayed reperfusion, and inferior infarction. Sufficient evaluation of the risk factors, close monitoring of vital signs, early identification of the specific symptoms, and timely treatment are the key points for the effective prediction and prevention of VDR.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Shi-Jian
authors.initials: SJ
authors.lastname: Chen
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.forename: Qing-Tao
authors.initials: QT
authors.lastname: Meng
authors.forename: Yong
authors.initials: Y
authors.lastname: Peng
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D006342:Heart Rupture, Post-Infarction / Q000150:complications*; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications; D008297:Male; D018658:Ventricular Septal Rupture / Q000150:complications