Left Ventricular Rupture after Acute Myocardial Infarction

"An 84-year-old man who had undergone remote four-vessel coronary artery bypass graft surgery presented to the emergency department with a 7-day history of worsening intermittent chest pain. Electrocardiography revealed ST-segment elevations in the inferior leads. Blood troponin levels were elevated. Emergent cardiac catheterization demonstrated occlusion of three coronary artery bypass graft vessels and an inferolateral left ventricular wall motion abnormality concerning for ventricular aneurysm. Nongated CT angiography of the chest revealed left ventricular inferolateral wall rupture (Figure, A) with bleeding into a large mediastinal hematoma that compressed the left atrium (Figure, B–D; Movie) (images acquired using Syngo.via VB60A-HF05; Siemens Healthineers). Informed of these findings, the patient’s family elected for comfort care, and the patient died 2 days later."

doi.org/10.1148/radiol.232257. PMID: 38652026.