The most common mechanical complications of acute myocardial infarction include free-wall rupture, ventricular septal rupture (VSR), papillary muscle rupture and pseudoaneurysm. It is rare for a patient to experience more than one mechanical complication simultaneously. Here, we present a case of ST-segment elevation myocardial infarction (STEMI) complicated with three mechanical complications, including ventricular apical wall rupture, ventricular aneurysm formation and ventricular septal dissection (VSD) with VSR. Cardiac auscultation revealed rhythmic S1 and S2 with a grade 3 holosystolic murmur at the left sternal border. Electrocardiogram indicated anterior ventricular STEMI. Serological tests showed a significant elevated troponin I. Bedside echocardiography revealed ventricular apical wall rupture, apical left ventricle aneurysm and VSD with VSR near the apex. This case demonstrates that several rare mechanical complications can occur simultaneously secondary to STEMI and highlights the importance of bedside echocardiography in the early diagnosis of mechanical complications.

中文翻译：

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ST 段抬高型心肌梗死导致心室心尖壁破裂和室壁瘤形成并发室间隔剥离和破裂：一例报告

急性心肌梗死最常见的机械并发症包括游离壁破裂、室间隔破裂（VSR）、乳头肌破裂和假性动脉瘤。患者同时经历一种以上机械并发症的情况很少见。在此，我们介绍一例 ST 段抬高型心肌梗死 (STEMI) 并发三种机械并发症的病例，包括心室心尖壁破裂、心室动脉瘤形成和室间隔夹层 (VSD) 伴 VSR。心脏听诊显示节律性 S1 和 S2，胸骨左缘有 3 级全收缩期杂音。心电图提示前室 STEMI。血清学检查显示肌钙蛋白 I 显着升高。床边超声心动图显示心室心尖壁破裂、左心室心尖部动脉瘤和室间隔缺损 (VSD)，且心尖附近存在 VSR。该病例表明，继发于 STEMI 后，几种罕见的机械并发症可能同时发生，并强调了床旁超声心动图在机械并发症早期诊断中的重要性。