Table 1 The timeline of the patient from admission to last follow-up
Two days before admission | The 79-year-old woman presented with chest pain for 5 days while the ECG was normal in the local hospital. |
|---|---|
On admission | She still presented with chest pain and the ECG showed STEMI in the anterior ventricle. |
Examination at admission | The patient had hypotension (90/64 mmHg), and the heart rate was 97 beats per minute. The heart rhythm was regular, and a grade 3 holosystolic murmur was heard at the left sternal border. |
Laboratory tests after admission | CK-MB was 124.6 ng/mL (0-3.6 ng/mL) TNI was 19.806 ng/mL (0-0.056 ng/mL) Myoglobin was 2035 ng/mL (10–92 ng/mL) D-dimer was 1660 ng/mL (0-500 ng/mL) NT-proBNP was 5468 pg/mL (0-450 pg/mL) |
Treatment after primary diagnosis | Aspirin 300Â mg, clopidogrel mg, and rosuvastatin 10Â mg were taken orally. The colloidal solution was given intravenously to expand blood volume. |
Bedside echocardiography | A ventricular aneurysm was formed at the apex of the left ventricle with a range of approximately 3.1 × 1.5 cm. A rupture of the apical ventricular wall was with a size of approximately 0.3–0.4 cm and a width of approximately 0.2–0.3 cm. A ventricular septal myocardial dissection was approximately 0.1–0.2 cm with a length of approximately 1.8 cm, which ruptured into the right ventricular cavity. |
Four hours after admission | The patient and her family refused further surgical operation or coronary angiography or further treatment and was discharged. |
After 1 week | The patient died at home. |