Non-ST-segment elevation myocardial infarction with evidence of transmural infarction complicated by left ventricular rupture during percutaneous coronary intervention.

We report a case of a 68-year-old man presenting with a non-ST-segment elevation myocardial infarction, complicated by fatal left ventricular free wall rupture with electromechanical disassociation and cardiac tamponade during percutaneous coronary intervention. The aetiology for the sudden haemodynamic collapse was initially unclear; however, transthoracic echocardiography confirmed pericardial tamponade and postmortem revealed complete transmural myocardial infarction with left ventricular free wall rupture. This serves as an important lesson that transmural infarction and subsequent mechanical complications, including ventricular rupture, can occur in non-ST-segment myocardial infarction and not just ST-segment myocardial infarction.