Magnetic Resonance Imaging of Impending Left Ventricular Rupture After Acute Myocardial Infarction
2003; Lippincott Williams & Wilkins; Volume: 108; Issue: 4 Linguagem: Inglês
10.1161/01.cir.0000079054.75843.7a
ISSN1524-4539
AutoresAntonello Zoni, Arianna Arisi, Domenico Corradi, Diego Ardissino,
Tópico(s)Coronary Artery Anomalies
ResumoHomeCirculationVol. 108, No. 4Magnetic Resonance Imaging of Impending Left Ventricular Rupture After Acute Myocardial Infarction Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBMagnetic Resonance Imaging of Impending Left Ventricular Rupture After Acute Myocardial Infarction Antonello Zoni, MD, Arianna Arisi, MD, Domenico Corradi, MD and Diego Ardissino, MD Antonello ZoniAntonello Zoni From the Division of Cardiology (A.Z., A.A., D.A.) and Department of Pathology and Laboratory Medicine (D.C.), University Hospital, Parma, Italy. , Arianna ArisiArianna Arisi From the Division of Cardiology (A.Z., A.A., D.A.) and Department of Pathology and Laboratory Medicine (D.C.), University Hospital, Parma, Italy. , Domenico CorradiDomenico Corradi From the Division of Cardiology (A.Z., A.A., D.A.) and Department of Pathology and Laboratory Medicine (D.C.), University Hospital, Parma, Italy. and Diego ArdissinoDiego Ardissino From the Division of Cardiology (A.Z., A.A., D.A.) and Department of Pathology and Laboratory Medicine (D.C.), University Hospital, Parma, Italy. Originally published29 Jul 2003https://doi.org/10.1161/01.CIR.0000079054.75843.7ACirculation. 2003;108:498–499A 63-year-old man with a history of arterial hypertension was admitted to the Cardiology Intensive Care Unit with an inferior acute myocardial infarction. The patient received 10+10 units of reteplase. Transthoracic echocardiogram showed an akinetic inferior wall and depressed systolic function (ejection fraction=40%). Cardiac MRI (Siemens Somaton Vision, 1.5 T) performed 4 days after the infarction for investigative purposes showed an infarct of the left ventricular inferior and posterior walls. The right ventricle was also partially involved. After gadolinium injection, a transmural serpiginous hypoenhancement signal was present in the infarcted area, consistent with myocardial hemorrhage and suggesting impending cardiac rupture (Figure 1). The patient suddenly died 5 hours after the MRI study. Autopsy showed an inferoposterior infarct involving the right ventricle. A myocardial rupture was present in the middle portion of the posterior wall corresponding to the hemorrhagic area detected by MRI (Figure 2). Histological examination showed myocardial necrosis and diffuse interstitial hemorrhage (Figure 3). Download figureDownload PowerPointFigure 1. Cardiac MRI of acute myocardial infarction. Gradient-echo fast low-angle shot (2D-FLASH) sequence after gadolinium dethylene triamine pentaacetic acid injection; note in the infarcted area a systolic hypoenhancement signal proceeding from the endocardium to the epicardium suggesting impending rupture (arrow).Download figureDownload PowerPointFigure 2. Cardiac rupture in middle portion of infarcted posterior wall (arrow).Download figureDownload PowerPointFigure 3. Histological examination. Left ventricular posterior free wall rupture (*) at the site of myocardial infarction. Insert (magnification of area indicated by arrow) shows injured myocytes with destruction of the architecture and diffuse interstitial hemorrhage. Hematoxylin and eosin; magnification in larger portion of figure, ×4. Bar=300 μm.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.FootnotesCorrespondence to Dr Antonello Zoni, Division of Cardiology, Ospedale Maggiore, Via Gramsci, 14, 43100 Parma, Italy. 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Divis P (2015) Successful conservative treatment of free wall rupture following acute myocardial infarction: the role of cardiac CT monitoring, JOURNAL OF HEART AND CARDIOLOGY, 10.15436/2378-6914.15.002, (1-2) July 29, 2003Vol 108, Issue 4 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000079054.75843.7APMID: 12885734 Originally publishedJuly 29, 2003 PDF download Advertisement
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