PMC9403242_01
A 12-lead electrocardiogram shows non-specific ST-segment changes in anterior leads.
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F1
His ECG demonstrated normal sinus rhythm with non-specific ST changes in anterior leads (Figure 1).
Echocardiogram of Left parasternal axis view shows no pericardial effusion.
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F2
ACS and was started on an ACS management protocol that includes aspirin, clopidogrel, statin, and subcutaneous heparin (enoxaparin 1 mg/kg twice daily). A transthoracic echocardiogram revealed a low normal ejection fraction (EF 50%) with mild anterior wall hypokinesia and no pericardial effusion; otherwise, no abnormality was detected (Figure 2).
Coronary angiogram: cranial view, showed LAD with large contained rupture in proximal segment causing pressure effect on the LAD.
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F3
TIMI II-III flow in the distal LAD (Figure 3).
Intraoperative photo showing the LAD spontaneous rupture with probe inside the opening (arrow).
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F4
The opening of spontaneous rupture in the LAD was identified as shown in Figure 4, and it was closed with a 3-0 polypropylene continuous suture.