BACKGROUND Mechanical complications are a rare presentation in chronic coronary syndromes,which have significantly decreased in the primary coronary intervention era.Incomplete rupture may occur,resulting in pseudoane...BACKGROUND Mechanical complications are a rare presentation in chronic coronary syndromes,which have significantly decreased in the primary coronary intervention era.Incomplete rupture may occur,resulting in pseudoaneurysms(PANs).Early reperfusion decreases the risk of this complication.Echocardiography is the method of choice for diagnosis.CASE SUMMARY A 54-year-old female hypertensive patient,with a history of non-revascularized inferior and anterior ST-segment elevation myocardial infarction(MI)4 years prior,was admitted to the cardiac unit of the hospital with complaints of abdominal pain and dyspnea lasting 2 mo.The patient was hemodynamically stable,and 12-lead electrocardiogram showed persistent ST elevation and Q wave in the inferior and apical regions.Transthoracic echocardiogram in the twochamber view showed a narrow neck of a wide PAN in the distal apical left ventricular inferior wall.In addition,the apical four-chamber and subcostal views revealed a second bulky PAN of the apical wall separated from the first by a common organizing thrombus.Cardiac magnetic resonance imaging confirmed the coexistence of more than one PAN.The patient received conservative medical treatment,and surgery was scheduled for outside the country.The patient had worsening multiple organ failure and died 4 wk after presentation.CONCLUSION Multifocal PANs rarely occur in chronic MI.Attention should be paid to patients with pain and cardiovascular risk factors.展开更多
Cardiac tamponade following blunt trauma results from cardiac rupture,leading to death even before the patient can receive medical attention.In such cases,the collected fluid(blood)in the pericardium inhibits the dias...Cardiac tamponade following blunt trauma results from cardiac rupture,leading to death even before the patient can receive medical attention.In such cases,the collected fluid(blood)in the pericardium inhibits the diastolic filling compressing the myocardium resulting in obstructive shock.We are reporting the case report of a 30-year-old male who was brought dead to the hospital with a history of road traffic accidents.The investigating officer informed that the deceased driver was not wearing a seat belt.Autopsy findings showed fresh blood clots of 600 g in the pericardial sac with rupture of the left ventricular wall of the heart.There were contusions on the anterior aspect of the vertebrae corresponding to the heart level.Although it is impossible to prevent all the cases of cardiac tamponade,we can avoid the ones resulting from trauma.This case intends to stress the importance of wearing a seat belt while driving a car to prevent fatal injuries.展开更多
文摘BACKGROUND Mechanical complications are a rare presentation in chronic coronary syndromes,which have significantly decreased in the primary coronary intervention era.Incomplete rupture may occur,resulting in pseudoaneurysms(PANs).Early reperfusion decreases the risk of this complication.Echocardiography is the method of choice for diagnosis.CASE SUMMARY A 54-year-old female hypertensive patient,with a history of non-revascularized inferior and anterior ST-segment elevation myocardial infarction(MI)4 years prior,was admitted to the cardiac unit of the hospital with complaints of abdominal pain and dyspnea lasting 2 mo.The patient was hemodynamically stable,and 12-lead electrocardiogram showed persistent ST elevation and Q wave in the inferior and apical regions.Transthoracic echocardiogram in the twochamber view showed a narrow neck of a wide PAN in the distal apical left ventricular inferior wall.In addition,the apical four-chamber and subcostal views revealed a second bulky PAN of the apical wall separated from the first by a common organizing thrombus.Cardiac magnetic resonance imaging confirmed the coexistence of more than one PAN.The patient received conservative medical treatment,and surgery was scheduled for outside the country.The patient had worsening multiple organ failure and died 4 wk after presentation.CONCLUSION Multifocal PANs rarely occur in chronic MI.Attention should be paid to patients with pain and cardiovascular risk factors.
文摘Cardiac tamponade following blunt trauma results from cardiac rupture,leading to death even before the patient can receive medical attention.In such cases,the collected fluid(blood)in the pericardium inhibits the diastolic filling compressing the myocardium resulting in obstructive shock.We are reporting the case report of a 30-year-old male who was brought dead to the hospital with a history of road traffic accidents.The investigating officer informed that the deceased driver was not wearing a seat belt.Autopsy findings showed fresh blood clots of 600 g in the pericardial sac with rupture of the left ventricular wall of the heart.There were contusions on the anterior aspect of the vertebrae corresponding to the heart level.Although it is impossible to prevent all the cases of cardiac tamponade,we can avoid the ones resulting from trauma.This case intends to stress the importance of wearing a seat belt while driving a car to prevent fatal injuries.
