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Survival after left ventricular free wall rupture in an elderly woman with acute myocardial infarction treated only medically.
MedLine Citation:
PMID:  22953155     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Pseudoaneurysm of the left ventricle is rare and may occur as a result of transmural myocardial infarction. The course of rupture after acute myocardial infarction varies from a catastrophic event, with an acute tear leading to immediate death (acute rupture), or slow and incomplete tear leading to a late rupture (subacute rupture). Incomplete rupture may occur when the thrombus and haematoma together with the pericardium seal the rupture of the left ventricle and may develop into a pseudoaneurysm. Early diagnosis and treatment is essential in this condition. Two-dimensional color Doppler echocardiography is the first-choice method for most patients with suspected left ventricular pseudoaneurysm (LVP) and suggests left ventricular rupture in 85% to 90% of patients. We report the case of an 87-year-old woman presenting with symptoms and findings of myocardial infarction and left ventricular free wall rupture with a pseudoaneurysm formation diagnosed by echocardiography and confirmed on CT, MRI, and NM. She received only intense medical treatment, because she refused surgery with a favorable outcome. After 24-month followup, she is in NYHA functional class II. The survival of this patient is due to the contained pseudoaneurysm by dense pericardial adhesions, related to her previous coronary bypass surgery.
Víctor Hugo Roa-Castro; Ervin Molina-Bello; Hector Valenzuela-Suárez; Tobías Rotberg-Jagode; Nilda Espinola-Zavaleta
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Publication Detail:
Type:  Journal Article     Date:  2012-03-26
Journal Detail:
Title:  Case reports in vascular medicine     Volume:  2012     ISSN:  2090-6994     ISO Abbreviation:  Case Rep Vasc Med     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-06     Completed Date:  2012-09-06     Revised Date:  2013-04-15    
Medline Journal Info:
Nlm Unique ID:  101585357     Medline TA:  Case Rep Vasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  728602     Citation Subset:  -    
Department of Clinical Cardiology, The American British Cowdray Medical Center IAP, Campus Observatorio, Sur 136 No. 116, Colonia Las Americas, Delegación Alvaro Obregón, 01120 Mexico City, DF, Mexico.
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