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European Journal of Echocardiography 2005 6(1):72-74; doi:10.1016/j.euje.2004.07.002
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Copyright © 2005, The European Society of Cardiology

Incomplete myocardial rupture after coronary embolism of an isolated single coronary artery

Javier Pindado, Pedro Marcos-Alberca*, Manuel Rey, Rosa Rábago, Carlos de Diego, Borja Ibáñez, Manuel Córdoba and Jerónimo Farré

Servicio de Cardiología, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain

Received 11 March 2004; received in revised form 22 June 2004; accepted after revision 1 July 2004.

* Corresponding author. Laboratorio de Ecocardiografía, Servicio de Cardiología, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Avenida Reyes Católicos 2, 28040 Madrid, Spain. Tel.: +34 91 550 48 56; fax: +34 91 549 70 33. pmarcos{at}fjd.es


  Abstract

An 82-year-old female was admitted to the coronary care unit with an anterior wall myocardial infarction and cardiogenic shock. She was in chronic atrial fibrillation without oral anticoagulation. Coronary angiography showed occlusion of the left main coronary artery which originated together with a normal right coronary artery from the right sinus of Valsalva. The advanced age, the presence of chronic atrial fibrillation not anticoagulated and the normal appearance of the remaining coronary arteries suggested a thromboembolic origin. Transthoracic echocardiography showed an abrupt interruption of the myocardial wall, in the apical portion of the interventricular septum, not communicating with the pericardial sac or right ventricular cavity suggesting the presence of an incomplete contained rupture of the myocardial wall at this location. She died in cardiogenic shock due to the extensive left ventricular damage.

Keywords: Atrial fibrillation; Myocardial infarction; Embolism; Complications


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