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Left Ventricular Free Wall Rupture
Stephan Achenbach, MD, FESC, FACC, FSCCT
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Rupture of left ventricular myocardial wall with ensuing communication between left ventricular cavity and pericardial space
              • Usually seen in setting of acute myocardial infarction
              • Often accompanied by acute hemodynamic deterioration or electromechanic dissociation
              • May be contained if inflammatory pericardium seals rupture
            • 3 forms of rupture
              • Acute: Acute tamponade with sudden electromechanical dissociation or severe hypotension
              • Subacute: Moderate to severe pericardial effusion
                • With tamponade and hemodynamic compromise
                • With modest or progressive hypotension
                • Without tamponade
              • Chronic: Incidental detection of contained rupture in long-term interval following myocardial infarction

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Echocardiographic Findings

                    • Angiographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Formica F et al: Postinfarction left ventricular free wall rupture: a 17-year single-centre experience. Eur J Cardiothorac Surg. 53(1):150-6, 2018
                                      2. Mujanovic E et al: Surgical treatment of left ventricular pseudoaneurysm. Med Arch. 68(3):215-7, 2014
                                      3. Haddadin S et al: Surgical treatment of postinfarction left ventricular free wall rupture. J Card Surg. 24(6):624-31, 2009
                                      4. Figueras J et al: Left ventricular free wall rupture: clinical presentation and management. Heart. 83(5):499-504, 2000
                                      5. Becker RC et al: A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction. J Am Coll Cardiol. 27(6):1321-6, 1996
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Rupture of left ventricular myocardial wall with ensuing communication between left ventricular cavity and pericardial space
                                                  • Usually seen in setting of acute myocardial infarction
                                                  • Often accompanied by acute hemodynamic deterioration or electromechanic dissociation
                                                  • May be contained if inflammatory pericardium seals rupture
                                                • 3 forms of rupture
                                                  • Acute: Acute tamponade with sudden electromechanical dissociation or severe hypotension
                                                  • Subacute: Moderate to severe pericardial effusion
                                                    • With tamponade and hemodynamic compromise
                                                    • With modest or progressive hypotension
                                                    • Without tamponade
                                                  • Chronic: Incidental detection of contained rupture in long-term interval following myocardial infarction

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Echocardiographic Findings

                                                        • Angiographic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Formica F et al: Postinfarction left ventricular free wall rupture: a 17-year single-centre experience. Eur J Cardiothorac Surg. 53(1):150-6, 2018
                                                                          2. Mujanovic E et al: Surgical treatment of left ventricular pseudoaneurysm. Med Arch. 68(3):215-7, 2014
                                                                          3. Haddadin S et al: Surgical treatment of postinfarction left ventricular free wall rupture. J Card Surg. 24(6):624-31, 2009
                                                                          4. Figueras J et al: Left ventricular free wall rupture: clinical presentation and management. Heart. 83(5):499-504, 2000
                                                                          5. Becker RC et al: A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction. J Am Coll Cardiol. 27(6):1321-6, 1996