• Zhi-Ping Zhang, Xi Su, Cheng-Wei Liu, Dan Song, Jian Peng, Ming-Xiang Wu, Yu-Chun Yang, Bo Liu, Cheng-Yi Xu, and Fang Wang.
• Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan 430022, China. Electronic address: blyynk@hotmail.com.
• Am J Emerg Med. 2016 Jan 1;34(1):120.e1-3.

AbstractLeft ventricular free wall rupture usually leads to acute hemopericardium and sudden cardiac death resulting in cardiac tamponade. Rarely, only a few patients with subacute free wall rupture such as oozing-type ventricular rupture or left ventricular false aneurysm may permit time for pericardiocentesis and surgery. We report a 63-year-old man with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention about 12 hours from the onset, and cardiac tamponade occurred on the second day. An intra-aortic balloon pump (IABP) was immediately inserted for hemodynamic support. After 100 mL of pericardial fresh blood was drained from the percardial cavity, his hemodynamic collapse was promptly improved with IABP support. In the following 24 hours, about 600 mL of hemorrhagic pericardial fluid was drained. The most likely diagnosis was concerning for oozing-type ventricular rupture, and a conservative approach was decided. The patient survived to the acute phase under IABP support and was discharged with complete recovery.

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