ABSTRACT
This chapter presents a case study of a 75-year-old man came to the emergency department because of chest pain. Three days earlier, he had developed chest pain that radiated to his left shoulder and left arm and that was associated with dyspnea, nausea and vomiting, and diaphoresis. On the morning of admission, he presented at his doctor's office with a heart rate of 32 beats per minute and electrocardiographic changes consistent with acute myocardial infarction. His blood pressure was 92/48 mm Hg; heart rate, 58 beats per minute; and respiratory rate, 16 breaths per minute, and he was afebrile. He was free of chest pain upon arrival to the coronary care unit. The posteromedial papillary muscle receives a single blood supply from posterior descending artery, making it more likely to become ischemic or rupture during an inferior wall AMI. Free wall rupture is second only to pump failure as a cause of death in AMI in the coronary care unit.
