Two-dimensional echocardiographic characteristics of pericardial hematoma secondary to left ventricular free wall rupture complicating acute myocardial infarction

Rupture of the left ventricular (LV) free wall is a common complication of acute myocardial infarction (AMI) and accounts for up to 10% of hospital deaths.¹ Infarct expansion may precede rupture,² whereas the rupture itself is usually associated with rapid hemodynamic deterioration from cardiac tamponade and leads to death. The potential for salvage of such patients is poor; however, under favorable circumstances (early identification and optimal hemodynamic support), some patients survive emergency surgical repair.3 Cases have been reported where echocardiography contributed to the diagnosis by demonstrating intrapericardial echo-densities and moderate effusion.^4-10 This report describes our observations of the 2-dimensional echocardiographic characteristics of LV free wall rupture in 7 patients with AMI.