Case Presentation: A 53-year-old female presented to the emergency department with three days of nausea and dyspnea on exertion after using methamphetamine. Initial electrocardiogram revealed an ST-elevation myocardial infarction. While awaiting transfer to the cardiac catheterization lab the patient suffered a witnessed cardiac arrest. During resuscitative efforts an enlarging pericardial effusion on point-of-care ultrasound led to the detection of a left ventricular free-wall rupture (LVFWR). This case illustrates the progression of a left ventricular free-wall rupture using point-of-care ultrasound.

Discussion: Left ventricular free-wall rupture has a low incidence rate in the setting of an acute myocardial infarction. Ultrasonography is the tool of choice for detecting a LVFWR.