A 68-year-old woman hospitalized 5 days post-transmural myocardial infarction presents with acute hemodynamic collapse. Vital signs show BP 70/45 mmHg, HR 120/min, RR 22/min, temp 37.8°C. She develops pulseless electrical activity and dies despite resuscitation. Autopsy reveals 400 mL blood in the pericardial sac. Troponin I was markedly elevated at admission. She denies chest pain currently. She takes aspirin and metoprolol. Which diagnosis best explains her presentation?
- A)Papillary muscle rupture
- B)Ventricular septal rupture
- C)Ventricular aneurysm
- D)Dressler syndrome
- E)Free wall ruptureGABARITO
Explicação
Free wall rupture is correct. Several days after a transmural MI, macrophage mediated degradation of necrotic myocardium weakens the wall and can lead to rupture with hemopericardium and tamponade. This catastrophic complication often presents with sudden PEA ... Ver explicação completa e trilha adaptativa →