Presentation with pulsatile xiphisternal bruise …

Pinto, N., et al. (2011). "Presentation with pulsatile xiphisternal bruise-Survival with a chronic ventricular rupture." Heart Lung and Circulation 20(2): 132-135.

Ventricular free wall rupture is an acute, severe complication of myocardial infarction (MI). Accounting for 20-30% of MI mortality, ventricular rupture is fatal if not detected early and repaired surgically. The unique case of a delayed, chronic rupture is reported in a 64 year-old male who presented with a painless, pulsatile, sub-xiphisternal bruise, five years post MI. Trans-thoracic echocardiography (TTE) revealed haematoma extending posteriorly with only contrast echocardiography revealing an active communication between the sub-dermal area and the heart. Urgent surgery and a prolonged period in ICU enabled sufficient enough recovery for discharge. (Heart, Lung and Circulation 2011;20:132-135) Crown Copyright (C) 2010 Published by Elsevier Inc. on behalf of Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. All rights reserved.