Li XP, Wang ZS, Yu HX, Wang SS. Successful emergency surgical intervention in acute non-ST-segment elevation myocardial infarction with rupture: A case report. World J Clin Cases 2025; 13(4): 100375 [DOI: 10.12998/wjcc.v13.i4.100375]
Corresponding Author of This Article
Zi-Shan Wang, Department of Cardiovascular Medicine, Huantai County Hospital of Traditional Chinese Medicine, North Head of Xinghuan Road, Huantai County, Zibo 256400, Shandong Province, China. 409838190@qq.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2025; 13(4): 100375 Published online Feb 6, 2025. doi: 10.12998/wjcc.v13.i4.100375
Successful emergency surgical intervention in acute non-ST-segment elevation myocardial infarction with rupture: A case report
Xing-Po Li, Zi-Shan Wang, Hong-Xia Yu, Shan-Shan Wang
Xing-Po Li, Zi-Shan Wang, Hong-Xia Yu, Department of Cardiovascular Medicine, Huantai County Hospital of Traditional Chinese Medicine, Zibo 256400, Shandong Province, China
Shan-Shan Wang, Department of Cardiovascular Medicine, Zibo Hospital of Integrated Traditional Chinese and Western Medicine, Zibo 255500, Shandong Province, China
Author contributions: Li XP was responsible for the revision of the manuscript and contributed to manuscript drafting; Wang ZS reviewed resonance imaging and selected the figures; Yu HX contributed to the conception and revision of the manuscript; Wang SS wrote the manuscript; and all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Shan Wang, Department of Cardiovascular Medicine, Huantai County Hospital of Traditional Chinese Medicine, North Head of Xinghuan Road, Huantai County, Zibo 256400, Shandong Province, China. 409838190@qq.com
Received: August 14, 2024 Revised: October 13, 2024 Accepted: November 1, 2024 Published online: February 6, 2025 Processing time: 92 Days and 13.4 Hours
Abstract
BACKGROUND
The incidence of acute myocardial infarction (AMI) is rising, with cardiac rupture accounting for approximately 2% of deaths in patients with acute ST-segment elevation myocardial infarction (STEMI). Ventricular free wall rupture (FWR) occurs in approximately 2% of AMI patients and is notably rare in patients with non-STEMI. Types of cardiac rupture include left ventricular FWR, ventricular septal rupture, and papillary muscle rupture. The FWR usually leads to acute cardiac tamponade or electromechanical dissociation, where standard resuscitation efforts may not be effective. Ventricular septal rupture and papillary muscle rupture often result in refractory heart failure, with mortality rates over 50%, even with surgical or percutaneous repair options.
CASE SUMMARY
We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary angiography. Prompt resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient recovery.
CONCLUSION
This case emphasizes the risks of AMI complications, shares a successful treatment scenario, and discusses measures to prevent such complications.
Core Tip: Acute myocardial infarction (MI) is often complicated by mechanical disruptions such as free wall rupture or ventricular septal perforation, typically associated with ST-elevation MI, but rarely encountered in non-ST-segment elevation MI. Cardiac rupture leading to acute pericardial tamponade is frequently fatal. In this report, we describe an uncommon case of successful surgical intervention in a patient with non-ST-segment elevation MI complicated by cardiac rupture.
