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Case Reports
. 2019 Aug 7:20:1155-1158.
doi: 10.12659/AJCR.917217.

Fatal Right Ventricular Free Wall Rupture During Percutaneous Coronary Intervention for Inferior Acute Myocardial Infarction

Daisuke Ueno  1 , Tetsuya Nomura  1 , Kenshi Ono  1 , Yu Sakaue  1 , Yusuke Hori  1 , Kenichi Yoshioka  1 , Masakazu Kikai  1 , Natsuya Keira  1 , Tetsuya Tatsumi  1
Affiliations
Case Reports

Fatal Right Ventricular Free Wall Rupture During Percutaneous Coronary Intervention for Inferior Acute Myocardial Infarction

Daisuke Ueno et al. Am J Case Rep. .

Abstract

BACKGROUND Ventricular rupture is a complication of acute myocardial infarction (AMI) that results in hemopericardium and cardiac tamponade and has a high mortality rate. Most cases involve the left ventricular free wall, and there have been few previous reports of solitary right ventricular free wall rupture. This report is of a case of fatal right ventricular free wall rupture during percutaneous coronary intervention (PCI) for inferior acute myocardial infarction (AMI). CASE REPORT A 76-year-old woman underwent emergency coronary angiography following inferior AMI. During angiography and attempted percutaneous coronary intervention (PCI), sudden onset of cardiac arrest occurred due to cardiac tamponade. Blood was drained from the pericardium by pericardiocentesis. Despite of advanced cardiac support, the patient died. The post mortem findings showed a solitary right ventricular free wall rupture due to inferior myocardial infarction. CONCLUSIONS A rare case is presented of right ventricular free wall rupture following AMI that occurred during PCI. This case demonstrates that early diagnosis and management are required to prevent patient mortality.

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Conflict of interest statement

Conflict of interest: None declared

Conflict of interest

None.

Figures

Figure 1.
Figure 1.
Blood pressure was lost during catheter measurement (triangle)
Figure 2.
Figure 2.
Aortic and coronary angiography. (A) Injected contrast media remained at the aortic valve cusp (triangles). (B) Coronary angiography failed to cannulate the right coronary artery (RCA), and aortic angiography was performed.
Figure 3.
Figure 3.
Post mortem showed a solitary right ventricular free wall rupture due to inferior myocardial infarction (triangles).
See this image and copyright information in PMC

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