Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

Left Ventricular Rupture after Acute Myocardial Infarction

Left Ventricular Rupture after Acute Myocardial Infarction REVIEWS AND COMMENTARY IMAGES IN RADIOLOGY Ashley Elizabeth Prosper, MD • Cameron Hassani, MD From the Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd, Ste 420, Rm E, Los Angeles, CA 90024. Received August 29, 2023; revision requested October 23; final revision received December 10; accepted January 3, 2024. Address correspondence to A.E.P. (email: [email protected]). Conflicts of interest are listed at the end of this article. Supplemental material is available for this article. Radiology 2024; 311(1):e232257 https://doi.org/10.1148/radiol.232257 © RSNA, 2024 • • Images in an 84-year-old man with left ventricular rupture. (A) Nongated CT angiogram with curved planar oblique reformat reveals left ventricular inferolateral myocardial rupture (arrow) that is bleeding into a large mediastinal hematoma ( ), with resultant compression of the left atrium (LA) (arrow- heads). (B, C) Three-dimensional volumetric renderings in (B) left anterior oblique view and (C) left posterior oblique view depict active extravasation (arrow) from the left ventricular rupture and compression of the left atrium (arrowheads in B) by the associated hematoma (not depicted). (D) Same three-dimensional rendering as in C, but including the hematoma ( ). n 84-year-old man who had undergone remote four- Left ventricular free wall rupture after myocardial in- Avessel coronary artery bypass graft surgery presented farction is rare, occurring in 1% of cases (1). Treatment to the emergency department with a 7-day history of for acute myocardial rupture is surgical repair, despite worsening intermittent chest pain. Electrocardiography which mortality remains high, at 88% (1). CT imaging is revealed ST-segment elevations in the inferior leads. an invaluable tool for diagnosing left ventricular free wall Blood troponin levels were elevated. Emergent cardiac rupture and guiding management, especially in acute myo- catheterization demonstrated occlusion of three coro- cardial infarction, where emergent catheter-based manage- nary artery bypass graft vessels and an inferolateral left ment may not reveal the diagnosis. ventricular wall motion abnormality concerning for Disclosures of conflicts of interest: A.E.P. Grants or contracts from John- ventricular aneurysm. Nongated CT angiography of the son & Johnson, American College of Radiology, Wyeth Foundation, and chest revealed left ventricular inferolateral wall rupture National Institutes of Health; consulting fees from MedQIA; associate editor for Radiology: Imaging Cancer. C.H. No relevant relationships. (Figure, A) with bleeding into a large mediastinal he- matoma that compressed the left atrium (Figure, B–D; Reference Movie) (images acquired using Syngo.via VB60A-HF05; 1. Nozoe M, Sakamoto T, Taguchi E, Miyamoto S, Fukunaga T, Na- Siemens Healthineers). Informed of these findings, the kao K. Clinical manifestation of early phase left ventricular rupture patient’s family elected for comfort care, and the patient complicating acute myocardial infarction in the primary PCI era. J died 2 days later. Cardiol 2014;63(1):14–18. This copy is for personal use only. To order copies, contact [email protected] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

Left Ventricular Rupture after Acute Myocardial Infarction

Prosper, Ashley Elizabeth; Hassani, Cameron
Radiology , Volume 311 (1): 1 – Apr 23, 2024
Download PDF
1 page

Loading next page...
 
/lp/radiological-society-of-north-america-inc/left-ventricular-rupture-after-acute-myocardial-infarction-gXhqiXoqPp

References (1)

Publisher
Radiological Society of North America, Inc.
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/radiol.232257
Publisher site
See Article on Publisher Site

Abstract

REVIEWS AND COMMENTARY IMAGES IN RADIOLOGY Ashley Elizabeth Prosper, MD • Cameron Hassani, MD From the Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd, Ste 420, Rm E, Los Angeles, CA 90024. Received August 29, 2023; revision requested October 23; final revision received December 10; accepted January 3, 2024. Address correspondence to A.E.P. (email: [email protected]). Conflicts of interest are listed at the end of this article. Supplemental material is available for this article. Radiology 2024; 311(1):e232257 https://doi.org/10.1148/radiol.232257 © RSNA, 2024 • • Images in an 84-year-old man with left ventricular rupture. (A) Nongated CT angiogram with curved planar oblique reformat reveals left ventricular inferolateral myocardial rupture (arrow) that is bleeding into a large mediastinal hematoma ( ), with resultant compression of the left atrium (LA) (arrow- heads). (B, C) Three-dimensional volumetric renderings in (B) left anterior oblique view and (C) left posterior oblique view depict active extravasation (arrow) from the left ventricular rupture and compression of the left atrium (arrowheads in B) by the associated hematoma (not depicted). (D) Same three-dimensional rendering as in C, but including the hematoma ( ). n 84-year-old man who had undergone remote four- Left ventricular free wall rupture after myocardial in- Avessel coronary artery bypass graft surgery presented farction is rare, occurring in 1% of cases (1). Treatment to the emergency department with a 7-day history of for acute myocardial rupture is surgical repair, despite worsening intermittent chest pain. Electrocardiography which mortality remains high, at 88% (1). CT imaging is revealed ST-segment elevations in the inferior leads. an invaluable tool for diagnosing left ventricular free wall Blood troponin levels were elevated. Emergent cardiac rupture and guiding management, especially in acute myo- catheterization demonstrated occlusion of three coro- cardial infarction, where emergent catheter-based manage- nary artery bypass graft vessels and an inferolateral left ment may not reveal the diagnosis. ventricular wall motion abnormality concerning for Disclosures of conflicts of interest: A.E.P. Grants or contracts from John- ventricular aneurysm. Nongated CT angiography of the son & Johnson, American College of Radiology, Wyeth Foundation, and chest revealed left ventricular inferolateral wall rupture National Institutes of Health; consulting fees from MedQIA; associate editor for Radiology: Imaging Cancer. C.H. No relevant relationships. (Figure, A) with bleeding into a large mediastinal he- matoma that compressed the left atrium (Figure, B–D; Reference Movie) (images acquired using Syngo.via VB60A-HF05; 1. Nozoe M, Sakamoto T, Taguchi E, Miyamoto S, Fukunaga T, Na- Siemens Healthineers). Informed of these findings, the kao K. Clinical manifestation of early phase left ventricular rupture patient’s family elected for comfort care, and the patient complicating acute myocardial infarction in the primary PCI era. J died 2 days later. Cardiol 2014;63(1):14–18. This copy is for personal use only. To order copies, contact [email protected]

Journal

Radiology – Radiological Society of North America, Inc.

Published: Apr 23, 2024

There are no references for this article.