Left atrial infarction: a case report and review of the literature

The American Journal of Forensic Medicine and Pathology
Kelly L Rose, Kim A Collins

Abstract

The majority of cardiac related deaths are due to ischemic heart disease, with the most common clinical scenario being severe coronary artery atherosclerosis resulting in left ventricular myocardial infarction. However, infarction of other cardiac chambers does occur, and often has specific clinical associations. We report a case of a 70-year-old man who suffered from left atrial infarction that resulted in a transmural rupture of his left atrium. The patient had a history of rheumatic heart disease, mitral valve stenosis, and severe atherosclerotic coronary artery disease. Four days before death, he underwent mitral valve replacement and left circumflex coronary artery bypass. Two days later, he developed atrial fibrillation. On the day of death, he had decreased mental status, questionable seizure activity, hematemesis, ventricular tachycardia, and eventually asystole. At autopsy, he had significant hemopericardium with a fibrinous pericarditis and bilateral hemothoraces (total blood volume: 1250 mL). A 0.1 to 0.2 cm left atrial transmural defect was identified. The prosthetic mitral valve was free of vegetations, and completely intact. Similarly, the left circumflex artery bypass graft was completely patent and unremarkable....Continue Reading

References

Oct 8, 1999·Arquivos brasileiros de cardiologia·R G Mendes, P R Evora
Jan 26, 2000·International Journal of Cardiology·S LokshynV Kuhlkamp
Jul 9, 2005·Journal of Electrocardiology·Michael C TjandrawidjajaUNKNOWN CAPTORS II Investigators
Jan 13, 2006·Circulation·Thomas ThomUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee

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Jan 1, 2011·Current Opinion in Cardiology

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