case_images: PMC9403242_01
case_images: A 12-lead electrocardiogram shows non-specific ST-segment changes in anterior leads.
case_images: fcvm-09-922180-g0001.jpg
case_images: PMC9403242_01_fcvm-09-922180-g0001.jpg
case_images: F1
case_images: His ECG demonstrated normal sinus rhythm with non-specific ST changes in anterior leads (Figure 1).
case_images: Echocardiogram of Left parasternal axis view shows no pericardial effusion.
case_images: fcvm-09-922180-g0002.jpg
case_images: PMC9403242_01_fcvm-09-922180-g0002.jpg
case_images: F2
case_images: ACS and was started on an ACS management protocol that includes aspirin, clopidogrel, statin, and subcutaneous heparin (enoxaparin 1 mg/kg twice daily). A transthoracic echocardiogram revealed a low normal ejection fraction (EF 50%) with mild anterior wall hypokinesia and no pericardial effusion; otherwise, no abnormality was detected (Figure 2).
case_images: Coronary angiogram: cranial view, showed LAD with large contained rupture in proximal segment causing pressure effect on the LAD.
case_images: fcvm-09-922180-g0003.jpg
case_images: PMC9403242_01_fcvm-09-922180-g0003.jpg
case_images: F3
case_images: TIMI II-III flow in the distal LAD (Figure 3).
case_images: Intraoperative photo showing the LAD spontaneous rupture with probe inside the opening (arrow).
case_images: fcvm-09-922180-g0004.jpg
case_images: PMC9403242_01_fcvm-09-922180-g0004.jpg
case_images: F4
case_images: The opening of spontaneous rupture in the LAD was identified as shown in Figure 4, and it was closed with a 3-0 polypropylene continuous suture.