Authors Age (in years) Gender Clinical presentation EKG finding Troponin (ng/ml) ECHO findings Catheterization findings Outcomes Autopsy findings Kumar et al. [9 ] 62 Female Weakness and lightheadedness ST elevation in I, II, and V5-V6 11.64 EF 30% and severely reduced LV systolic function in mid and distal segments and preserved at basal segments Nonstentable 50-75% stenosis at mid LAD artery Death Slit-like rupture at the mid portion of the posterior ventricular wall Zalewska-Adamiec et al. [11 ] 74 Female Chest pain Sinus rhythm with QS complex and ST segment elevation in V2-V6 2.041 Contractile disturbances in the apex and hyperkinesis of basal segments with EF 56% and cardiac tamponade No significant stenosis Surgical repair and good condition on discharge Not applicable Kudaiberdiev et al. [12 ] 63 Female Chest pain, lightheadedness, dyspnea Q waves in III and aVF, T wave inversions in lead II, III, and aVF, and ST-T abnormalities in V5-V6 0.0 LV dilatation EF (35%) moderate MR, hypoakinesia and thinning of LV inferolateral wall with rupture and cross-over blood shunt through two defects into the pericardium Patent coronary arteries Surgical repair and good condition on discharge Not applicable Sung et al. [13 ] 73 Female Chest pain and dyspnea ST elevation in V2-V5 1.3 Akinesis of mid to apical left ventricle with EF of 58% Patent coronary arteries Death Not performed Yoshida et al. [5 ] 78 Female Chest pain and dyspnea RBBB and ST elevation in V2-V6 with QS pattern Not mentioned Apical kinesis with wall thinning and massive pericardial effusion Patent coronary arteries In good condition after discharge Not applicable Indorato et al. [1 ] 70 Female Chest pain and nausea Not done Not done Not performed Not performed Death. Patient died en route to hospital Hemorrhagic infarction of LV apex. 0.4 cm line of ruptured myocardium from anterior to posterior wall at the apex Shams [14 ] 73 Male Clinical features of pulmonary edema Sinus tachycardia with Q waves and ST elevation in inferior leads and depression in anterolateral leads 2.840 Left ventriculography: akinesis in the middle and basal-inferior wall and in broad band of mid anterior, mid lateral, and mid septal parts of the left ventricle and hemopericardium. Bedside, limited echo shows cardiac tamponade Stenosis of all three major arteries. No signs of coronary occlusion Death Hemopericardium, perforation of LV free wall at upper posterior part Kurisu and Inoue [2 ] 81 Female Unconsciousness ST segment elevation in I, II, III, aVF, and V2-V6 Not mentioned Apical akinesia and basal hyperkinesis Patent coronary arteries Death Not performed Sacha et al. [6 ] 81 Female Chest pain Diffuse ST elevation in the precordial and limb leads 1.55 Balloon-like LV motion abnormalities with akinesis from mid to apical portions and hyperkinesis of base No coronary artery disease Death Hemopericardium with an LV free wall rupture measuring 10 mm in the apical region and no patent coronary arteries. Inside the heart, there was a mural thrombus in the apical area Jaguszewski et al. [15 ] 82 Female Chest pain St segment elevation from V1 to V5 14.82 Abnormal LV contraction with apical ballooning pattern with EF of 55% Patent coronary arteries Death Wide penetrating apical rupture as well as 1500 ml of thrombi and liquid blood in the pericardium Shinozaki et al. [16 ] 90 Female Chest pain ST segment elevation in aVL and V1-V4 Not mentioned LV apical akinesis and hyperkinesis of base Intact coronary arteries Death Not mentioned Akashi et al. [8 ] 70 Female Chest discomfort ST elevation in I, II, III, aVL, aVF, and V2-V6 Not mentioned Apical akinesis and basal hyperkinesis with EF of 51% Normal coronary arteries Death Not performed Showkathali et al. [17 ] 86 Female Chest pain ST segment elevation in anterolateral and inferior leads Not mentioned Shows TCM and no intraventricular gradient Normal RCA and mild atheromatous LAD artery Death Not mentioned Yamada et al. [18 ] 71 Female Shoulder and back pain St segment elevation in leads V4-V6 and abnormal Q waves in leads V4-V5 Not mentioned Left ventricular apical wall akinesis. Hyperkinesis in the basal wall with mitral valve systolic anterior wall motion No coronary artery stenosis Death Not performed Stöllberger et al. [19 ] 71 Female Generalized tonic clonic seizure ST segment elevation in II, II, avF, V5, and V6 Trop-T positive Left ventricular apical wall, apical septum, and apical posterior wall akinesia and small pericardial effusion Normal coronary arteries Death 5 mm left ventricular rupture in the apicoposterior region Ohara et al. [20 ] 79 Female Chest pain ST segment elevation in 1, aVL, and V1-V5; depression in leads III and avF; and abnormal Q wave in V1-V4 Not mentioned Akinesis of the left ventricular apical wall Patent coronary arteries Death Rupture in the anterior portion of the left ventricle, patent coronary arteries, and hemopericardium Mafrici et al. [21 ] 87 Female Chest pain and dyspnea ST segment elevation in inferior leads and V2-V6 Trop-T: 20 Apical dyskinesis with hyperkinesis of left ventricular basal segment Patent coronary arteries Death Not performed Ishida et al. [22 ] 67 Female Chest pain ST segment elevation in I, avL, and V2-V5 Not mentioned Apical ballooning, basal hyperkinesis, and left ventricular outflow pressure gradient of 110 mmHg associated with systolic anterior movement of anterior mitral leaflet Extensive akinesis from the apex to mid portion Surgical repair to correct the cardiac rupture slit Not applicable Leva et al. [23 ] 65 Female Chest pain and dyspnea ST segment elevation in anterior leads Not mentioned Akinesis from mid to apical LV and basal hyperkinesis, EF of 30% No significant stenosis of epicardial coronary arteries Death Not mentioned Iskander et al. [24 ] 77 Female Unconsciousness, chest pain, and dyspnea ST segment. Elevation in leads I, aVL, and V2-V6 Trop-T: 3.60 EF of 25%. Severe dyskinesis of anterolateral wall of LV, no LVOT obstruction No coronary artery obstruction with slow flow down the LAD Death Fresh clot on epicardial surface, slit-like rupture on anteroapical surface of LV Present case 75 Female Chest pain and dyspnea Sinus rhythm, no ST segment elevation, poor R wave progression 6.80 EF of 30-35%, severe hypokinesis of apical LV, and asymmetric hypertrophy of the basal septum Not performed Death Hemopericardium, patent epicardial coronary arteries, slit-like
