Cardiac Amyloidosis Causing Free Wall Rupture During an Exercise Stress Test: A Case Report and Review of the Literature

Background: There are three major mechanical complications from acute myocardial infarction: left ventricular free-wall rupture, ventricular septum rupture and acute mitral valve regurgitation. The left ventricular free-wall rupture is a serious and often lethal complication, typically following an ST elevation myocardial infarction. Free wall rupture outside the setting of a recent ST elevation myocardial infarction is very unusual. Furthermore, rupture during stress testing is extremely uncommon with very few cases in the literature. In addition to causing restrictive cardiomyopathies, cardiac amyloidosis can also cause severe ischemia with potentially catastrophic complications including free wall rupture.