Ventricular free wall rupture is an acute, severe complication of myocardial infarction (MI). Accounting for 20-30% of MI mortality, ventricular rupture is fatal if not detected early and repaired surgically. The unique case of a delayed, chronic rupture is reported in a 64 year-old male who presented with a painless, pulsatile, sub-xiphisternal bruise, five years post MI. Trans-thoracic echocardiography (TTE) revealed haematoma extending posteriorly with only contrast echocardiography revealing an active communication between the sub-dermal area and the heart. Urgent surgery and a prolonged period in ICU enabled sufficient enough recovery for discharge.
2010. Published by Elsevier Inc on behalf of Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand.All rights reserved.