Left ventricular free wall rupture and hemo-pericardium in Sudden death-A case report

Sudden deaths may involve almost any organ system and the most common system involved is cardiovascular system. Death may be the initial manifestation of certain cardiac pathology. Myocardial rupture is one of the rare cardiac event, which is usually fatal and the outcome depends on the size of rupture and rate of pericardial blood collection. Myocardial rupture can occur in various traumatic, nontraumatic and iatrogenic conditions. A 40-year old male, with no previous history of coronary artery disease, was brought dead to casualty. At autopsy, hemopericardium and a tear in left ventricular free wall was noted. Left coronary artery was stenosed. Histopathological section from the heart showed numerous neutrophil infiltrates suggestive of acute myocardial infarction. In myocardial infarction, a number of factors like age, gender, previous myocardial infarct, site of infarct, ventricular hypertrophy, wall thickness affected and intake of non-steroidal anti-inflammatory drugs, play a role in rupturing the myocardium.