A Heart Condition Where 8 Out of 10 Patients Don’t Survive: A Rare Case of Left Ventricular Wall Rupture

When 71-year-old Baljeet Kaur, a homemaker from Faridabad, was rushed to Sarvodaya Hospital, Sec 8, Faridabad with severe chest pain and breathlessness, doctors diagnosed her with a rare and usually fatal complication of a massive heart attack. Caused by a 100% blockage in a major heart artery, the condition led to a sudden rupture in the wall of her heart, medically termed post–myocardial infarction left ventricular free wall rupture—a medical emergency in which nearly 8 out of 10 patients do not survive even with surgery. With her condition rapidly deteriorating, she underwent immediate high-risk emergency heart surgery led by Dr. Anupam Das, Senior Consultant & Head - Cardiothoracic & Vascular Surgery along with Dr. Murtaza, supported by Dr. Seema Jain (Anaesthesiology) and a specialized CTVS surgical and critical care team, giving her the only chance of survival.

What is Left Ventricular Wall Rupture?

Following the heart attack, the damaged heart muscle became extremely thin. Within two days, this weakened area developed a tear, allowing blood to leak into the sac surrounding the heart. This condition is medically known as Post Myocardial Infarction Left Ventricular Free Wall Rupture.

In simple terms, the wall of the heart cracked open, leading to rapid internal bleeding. Without immediate surgical treatment, this condition results in almost certain death within 24 to 48 hours.

A Rare and Often Fatal Complication after a Heart Attack

Left ventricular wall rupture is extremely uncommon, occurring in only 0.8% to 6.2% of patients who suffer a major heart attack. Despite its rarity, it carries a devastating prognosis. Even with emergency surgery, the risk of death remains as high as 75–80%, even in the most advanced cardiac centers across the world.

Warning Signs that could not be ignored

Mrs. Kaur had been experiencing chest pain for two days before her condition worsened dramatically. On the day of the rupture, she developed:

• Severe breathlessness
• Increasing chest pain
• Low blood pressure
• Drowsiness and signs of shock

These symptoms indicated a catastrophic cardiac event requiring immediate medical intervention.

A Race against Time: Why Emergency Surgery was the only Option

Given the life-threatening nature of the condition, the medical team knew that even a short delay could prove fatal. Mrs. Kaur was stabilized and shifted to the operating theatre within 60 minutes.

Advanced life-support measures were initiated, including heart-support medications and insertion of an intra-aortic balloon pump (IABP) to assist the failing heart. There was no scope to wait—the surgery had to be performed on an emergency basis.

Inside the Operating Room: A Six-Hour High-Risk Heart Surgery

The six-hour surgery was led by Dr. Anupam Das, along with Dr. Murtaza, supported by an experienced team of anaesthesiologists, perfusionists, operation theatre staff, and dedicated CTVS ICU nurses.

During surgery, the chest was opened and nearly 1.5 liters of clotted and fresh blood was removed from around the heart. The damaged portion of the heart wall was repaired using bovine pericardium and a Dacron patch to reinforce the fragile muscle. Simultaneously, the blocked coronary artery (LAD) was bypassed using a vein graft to restore blood supply to the heart.

The procedure, known as Left Ventricular Wall Rupture Repair with Coronary Artery Bypass Grafting (CABG), is regarded as one of the most technically challenging surgeries in cardiac care.

Why this Surgery is Considered One of the Most Challenging

This surgery is rarely performed due to the extremely poor condition of patients at presentation. The fragile heart tissue, ongoing bleeding, and severe shock make the operation highly complex. Successful outcomes depend on rapid diagnosis, immediate surgical decision-making, technical expertise, and seamless coordination across multiple medical teams.

Critical Days in the ICU: The Road to Recovery

After surgery, Mrs. Kaur was shifted to the cardiac ICU on strong heart-support medications and mechanical circulatory support. She required close monitoring, blood transfusions, and intensive care.

She was successfully taken off the ventilator on Day 3, showed steady improvement, and was shifted out of the ICU on Day 6. Her recovery continued gradually over the next few days.

A Story That Highlights the Power of Timely Cardiac Care

This rare case highlights the importance of recognizing heart attack symptoms early and seeking immediate medical attention. It also demonstrates how advanced cardiac infrastructure, surgical expertise, and coordinated post-operative care can save lives even in the most critical situations.

For patients facing life-threatening heart conditions, timely intervention truly makes the difference between life and death.