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Clinical introduction
An 85-year-old woman with no known coronary risk factors presented to the ED with a 5-day history of epigastric pain and sudden onset of dyspnoea. Her vital signs on arrival were unstable. Her BP was 68/38 mm Hg, and heart rate was 120 beats per minute. Physical examination revealed a harsh holosystolic murmur at the left sternal border and no peripheral oedema. The ECG (figure 1) and transthoracic echocardiography (figure 2, online supplemental video 1) were performed.
Supplementary video
Question
What is the likely diagnosis?
Left ventricular free-wall rupture.
Ventricular septal rupture.
Papillary muscle rupture.
Pseudoaneurysm.
Answer
Answer: B. Ventricular septal rupture (VSR) …
Footnotes
Contributors RO contributed to patient management, conception and design of case report; acquisition, analysis and interpretation of data; and drafting the article. SO and YK contributed to interpretation of data and revising the article critically. All authors gave final approval of the article and have agreed to be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.
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