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

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

(Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Nantan, Kyoto, Japan)

Am J Case Rep 2019; 20:1155-1158

DOI: 10.12659/AJCR.917217

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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