CASE REPORT article

Front. Cardiovasc. Med.

Sec. General Cardiovascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1502336

This article is part of the Research TopicCase Reports in General Cardiovascular Medicine: 2024View all 10 articles

Rupture of the cardiac free wall after myocardial infarction confirmed by aortic Computed tomography angiography

Provisionally accepted
Jie  LiuJie LiuWeiqing  ChenWeiqing ChenZihan  LiZihan LiNan  LiuNan LiuCuiying  MaoCuiying Mao*
  • China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China

The final, formatted version of the article will be published soon.

Introduction Free wall rupture is a rare complication of myocardial infarction, occurring as early as a few hours after myocardial infarction. It usually happens after transmural myocardial infarction and has a very high mortality rate. The diagnosis of free wall rupture requires echocardiographic evidence of pericardial leakage or pericardial tamponade. The patient's cause of death is often attributed to other causes such as cardiac arrhythmia unless determined by open heart surgery or autopsy. Diagnostic tools for post-infarction cardiac free wall rupture are limited to date.We present a case of myocardial infarction in a patient who presented with atypical chest pain. Subsequent coronary angiography revealed small vessel disease, however, the patient's severe clinical presentation was not consistent with small vessel disease. The initial clinical presentation did not rule out aortic dissection, prompting further investigation through aortic computed tomography. This imaging technique revealed a rupture of the free wall of the heart accompanied by a large amount of bloody pericardial effusion. Unfortunately, attempts to puncture and drain the effusion were unsuccessful and the patient eventually succumbed.Conclusions When patients present with more severe clinical manifestations that are not consistent with myocardial infarction, it is important to be alert to the possibility of cardiac rupture in addition to identifying the possibility of aortic dissection. Aortic CTA may be able to confirm the diagnosis of cardiac rupture.

Keywords: Cardiac rupture1, Free wall rupture2, Aortic computed tomography angiography3, diagnosis4, myocardial infarction5

Received: 26 Sep 2024; Accepted: 29 May 2025.

Copyright: © 2025 Liu, Chen, Li, Liu and Mao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Cuiying Mao, China-Japan Union Hospital, Jilin University, Changchun, 130033, Jilin Province, China

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