Ventricular double rupture following myocardial infarction: a case report
and literature review
Dublin Core
Title
Ventricular double rupture following myocardial infarction: a case report
and literature review
and literature review
Subject
Acute myocardial infarction, Mechanical complications, Ventricular rupture, Surgical treatment, Echocardiography
Description
Abstract
Background The frequency of mechanical complications related to transmural myocardial infarction (MI) has
decreased due to the widespread implementation of reperfusion therapies. However, mortality related to these
complications remains high, requiring prompt intervention by a Heart Team. Ventricular double rupture (VDR) is a
particularly rare and fatal MI complication.
Case presentation A 58-year-old female patient presenting with 3 days of chest pain was diagnosed with
ST-elevation MI. She underwent primary percutaneous coronary intervention of the left anterior descending
artery. Transthoracic echocardiogram revealed an apical ventricular septum rupture and a mild pericardial
effusion suggestive of free wall rupture. Emergent surgical repair included ventricular septal defect closure with
a heterologous pericardial patch and repair of the free wall rupture with Dacron patch placement. Perioperative
intraaortic balloon pump support was utilized. The patient had a favorable clinical course and was asymptomatic at
her cardiology follow-up.
Conclusions VDR is the combination of two types of mechanical complications of MI. High clinical suspicion is
necessary in hemodynamically unstable patients and those with risk factors for myocardial rupture, warranting
echocardiographic evaluation for its diagnosis and characterization. Treatment of VDR is primarily surgical and may
involve mechanical circulatory support (MCS). Despite advances in reperfusion therapies and surgical techniques,
the prognosis of VDR remains poor. Our patient had a favorable outcome highlighting the importance of a
multidisciplinary approach.
Keywords Acute myocardial infarction, Mechanical complications, Ventricular rupture, Surgical treatment,
Echocardiography
Background The frequency of mechanical complications related to transmural myocardial infarction (MI) has
decreased due to the widespread implementation of reperfusion therapies. However, mortality related to these
complications remains high, requiring prompt intervention by a Heart Team. Ventricular double rupture (VDR) is a
particularly rare and fatal MI complication.
Case presentation A 58-year-old female patient presenting with 3 days of chest pain was diagnosed with
ST-elevation MI. She underwent primary percutaneous coronary intervention of the left anterior descending
artery. Transthoracic echocardiogram revealed an apical ventricular septum rupture and a mild pericardial
effusion suggestive of free wall rupture. Emergent surgical repair included ventricular septal defect closure with
a heterologous pericardial patch and repair of the free wall rupture with Dacron patch placement. Perioperative
intraaortic balloon pump support was utilized. The patient had a favorable clinical course and was asymptomatic at
her cardiology follow-up.
Conclusions VDR is the combination of two types of mechanical complications of MI. High clinical suspicion is
necessary in hemodynamically unstable patients and those with risk factors for myocardial rupture, warranting
echocardiographic evaluation for its diagnosis and characterization. Treatment of VDR is primarily surgical and may
involve mechanical circulatory support (MCS). Despite advances in reperfusion therapies and surgical techniques,
the prognosis of VDR remains poor. Our patient had a favorable outcome highlighting the importance of a
multidisciplinary approach.
Keywords Acute myocardial infarction, Mechanical complications, Ventricular rupture, Surgical treatment,
Echocardiography
Creator
Camilo Andres Calderon-Miranda1,2*, Carlos Enrique Vesga-Reyes1,2, Pastor Olaya1,2, Maria Juliana Reyes-Cardona2,3,
Jairo Sanchez-Blanco1,2, Jorge Alexander Zambrano-Franco1,2, Gustavo Adolfo Cruz-Suarez2,4 and
Alvaro Diego Peña-Gonzalez2,5
Jairo Sanchez-Blanco1,2, Jorge Alexander Zambrano-Franco1,2, Gustavo Adolfo Cruz-Suarez2,4 and
Alvaro Diego Peña-Gonzalez2,5
Source
https://doi.org/10.1186/s12245-025-00907-2
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Camilo Andres Calderon-Miranda1,2*, Carlos Enrique Vesga-Reyes1,2, Pastor Olaya1,2, Maria Juliana Reyes-Cardona2,3,
Jairo Sanchez-Blanco1,2, Jorge Alexander Zambrano-Franco1,2, Gustavo Adolfo Cruz-Suarez2,4 and
Alvaro Diego Peña-Gonzalez2,5, “Ventricular double rupture following myocardial infarction: a case report
and literature review,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12814.
and literature review,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12814.