CASE AT A GLANCE
Cardiac Rupture Following Heart Attack

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Case Overview:

A 79-year-old woman was seen at the ER with chest pain. The EKG showed an anterior ST elevation myocardial infarction. She was transferred to another hospital and immediately taken to the cardiac catheterization lab. It was discovered that she had a 100% occlusion of the mid-LAD. A stent was placed and the procedure appeared uncomplicated. An echocardiogram was done, which showed trace pericardial effusion but no evidence of cardiac tamponade. She did have some slight chest pain upon discharge but had extensive testing, and she was cleared to go home. A few days later visiting nurses did note that there was no report of recurrent chest pain or shortness of breath with normal vital signs. Also, during this time, a visiting physical therapist noted she was pain-free and ambulatory. A couple of days after this, she was found unresponsive by her son. She was determined to be dead upon arrival at the hospital, and on autopsy, 300cc of blood-tinged fluid, and 200cc of clotted blood were found within the pericardium. Cardiac tamponade was the cause of death as there was a rupture of the left ventricle at the site of the infarction. The jury found in favor of the defense.