{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:30:06Z","timestamp":1782167406781,"version":"3.54.5"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Free wall rupture is a rare complication of myocardial infarction, occurring as early as a few hours after myocardial infarction. It usually happens after transmural myocardial infarction and has a very high mortality rate. The diagnosis of free wall rupture requires echocardiographic evidence of pericardial leakage or pericardial tamponade. The patient's cause of death is often attributed to other causes such as cardiac arrhythmia unless determined by open heart surgery or autopsy. Diagnostic tools for post-infarction cardiac free wall rupture are limited to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present a case of myocardial infarction in a patient who presented with atypical chest pain. Subsequent coronary angiography revealed small vessel disease, however, the patient's severe clinical presentation was not consistent with small vessel disease. The initial clinical presentation did not rule out aortic dissection, prompting further investigation through aortic computed tomography. This imaging technique revealed a rupture of the free wall of the heart accompanied by a large amount of bloody pericardial effusion. Unfortunately, attempts to puncture and drain the effusion were unsuccessful and the patient eventually succumbed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When patients present with more severe clinical manifestations that are not consistent with myocardial infarction, it is important to be alert to the possibility of cardiac rupture in addition to identifying the possibility of aortic dissection. Aortic CTA may be able to confirm the diagnosis of cardiac rupture.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1502336","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T05:30:07Z","timestamp":1750311007000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Rupture of the cardiac free wall after myocardial infarction confirmed by aortic computed tomography angiography"],"prefix":"10.3389","volume":"12","author":[{"given":"Jie","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiying","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e8439","DOI":"10.1002\/ccr3.8439","article-title":"Ventricular silent rupture leading to sudden death: navigating diagnostic challenges in a resource-constraint setting","volume":"12","author":"Pallangyo","year":"2024","journal-title":"Clin Case Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1378\/chest.72.5.618","article-title":"Effect of hypertension on myocardial rupture after acute myocardial infarction","volume":"72","author":"Christensen","year":"1977","journal-title":"Chest"},{"key":"B3","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/0002-9149(94)90098-1","article-title":"Frequency of left ventricular free wall rupture complicating acute myocardial infarction since the advent of thrombolysis","volume":"74","author":"Pollak","year":"1994","journal-title":"Am J Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1378\/chest.92.2.219","article-title":"Cardiac rupture in patients with acute myocardial infarction","volume":"92","author":"Shapira","year":"1987","journal-title":"Chest"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1016\/S0735-1097(00)00878-0","article-title":"Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the SHOCK trial registry. 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