LEFT VENTRICULAR FREE WALL RUPTURE REVEALED BY PERIPROCEDURAL ECHOCARDIOGRAPHY IN A PATIENT WITH EXTENSIVE ANTERIOR STEMI: A FATAL CASE REPORT

Introduction: Left ventricular (LV) rupture is a rare but often fatal complication of acute myocardial infarction (AMI). Its diagnosis relies heavily on urgent imaging,particularly echocardiography.

Case presentation: We report the case of a 58-year-old woman with no known cardiovascular risk factors, admitted for acute chest pain that began 6 hours prior. The electrocardiogram (ECG) revealed an extensive anterior ST-elevation myocardial infarction (STEMI). While being transferred to the catheterization lab, she suddenly developed agonal breathing and electromechanical dissociation. Emergent transthoracic echocardiography demonstrated a left ventricular free wall rupture with massive hemopericardium. Despite 45 minutes of cardiopulmonary resuscitation,the patient died.

Conclusion: This case illustrates the dramatic course of LV rupture during the acute phase of myocardial infarction, highlighting the crucial role of echocardiography for immediate diagnosis in the cath lab.