Myocardial rupture associated with bolus injection of contrast medium during computed tomographic study in a patient with acute myocardial infarction: a rare but lethal complication

Contrast-enhanced computed tomographic (CT) scans are being performed daily for many reasons. They are especially useful for the evaluation of patients with acute chest symptoms because myocardial infarction, pulmonary embolism, and aortic dissection have overlapping clinical presentations. Indeed, advances in technology and the introduction of multidetector CT scan have enabled better evaluation of the heart. Yet, the potential risks to the cardiovascular system of using a bolus injection of contrast medium, although rare, should not be ignored or underrated. Here, we report a rare case of complicated left ventricular free wall rupture after a single bolus injection of contrast medium during a CT study in an elderly woman with acute myocardial infarction. Such a case has not been reported in the literature to date. This should alert us to the potential, if rare, complications that use of a bolus injection of contrast medium may induce, and lead to more cautious use of contrast medium in the future.