PMC9808968_01
Intraoperative observations: right side decubitus position; left heart exposed; left side posterior wall rupture has been sutured; there is still continuous bleeding.
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F1
After the removal of the hematocele and clots, the left heart was bare and the pericardium was absent (see Figure 1).
(A) Sinus rhythm, abnormal Q-wave and ST-segment elevation on I and aVL, suggesting acute high lateral myocardial infarction. (B) Sinus rhythm, abnormal Q-waves on I and aVL, suggesting high lateral myocardial infarction. (C) Sinus rhythm, no obvious abnormality on I and aVL. (D) Sinus tachycardia, ST-segment depression on I and aVL, suggesting increased myocardial ischemia. Analyses the ECG results, 1 day before cardiac rupture, QRS voltage on I and aVL was significantly lower.
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F2
The electrocardiogram (ECG) indicated a high wall myocardial infarction (see Figure 2).
Time courses of troponin (cTn) and myoglobin (Myo).
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F3
The troponin was 8.434 mug/L (see Figure 3).
Computed tomography (CT) images in different window settings: As the blue arrow shows, there is no obvious pericardial structure in the left area of pulmonary artery, which is closely related to lung tissue and has irregular edge; as the red arrow shows, there is an abnormal notch near the pulmonary artery, which is rare when the pericardium is intact.
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F4
Computed tomography (CT) indicated "multiple rib fracture on the left side, hydropneumothorax on the left side, no obvious abnormality in the skull and abdomen"(see Figures 4, 5).
Abdominal CT: the blue arrow shows intrathoracic drain; the red arrow shows that there appears to be exudate around the spleen; the splenic hilum appears to be intact.
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F5
Computed tomography (CT) indicated "multiple rib fracture on the left side, hydropneumothorax on the left side, no obvious abnormality in the skull and abdomen"(see Figures 4, 5).
Timeline.
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F6
The figure below shows a timeline of the patient's medical history (see Figure 6).