423 Up Against the Wall - Emergency Double Myocardial Rupture Repair

Abstract Background Left ventricular free wall rupture (LVFWR) and interventricular septal (VSR) are potentially catastrophic mechanical complications after acute myocardial infarction (AMI). When they occur together ("double rupture" (DMR)), survival is unlikely. DMR seen in only 0.3% of all AMIs. With or without surgical intervention, the odds against patient. Case presentation Our 57-year-old male patient self-referred to emergency department a remote hospital 5 days first experiencing chest pain. Investigations ED confirmed an inferior ST-segment elevation (STEMI) complicated by DMR. Coronary angiography revealed mid-course total occlusion right coronary artery (RCA). He was rapidly transferred our regional cardiac unit, arriving at theatre cardiogenic shock but conscious before arresting being massaged onto bypass. Not did he survive all-night operation, requiring mitral valve replacement process, survived multiple ITU be eventually transferred, neurologically intact, on postoperative day 66 peripheral unit complete his rehabilitation. has been discharged from rehabilitation centre 88 now able ambulate with walking frame. Conclusions patient, odds, complications. We present details case literature surrounding condition. hope patients meagre probabilities, such as this case, not given up on; hence, final message report persevere persist odds.