Cardiology: free wall rupture: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Cardiology: free wall rupture

Sample item

A patient 5 days after MI suddenly loses consciousness with an ECG showing organised rhythm but no pulse. Neck veins are distended just before collapse. What is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Left ventricular free wall rupture with tamponade

Free wall rupture causes haemopericardium and tamponade, producing pulseless electrical activity. It typically occurs 3-7 days after a transmural MI when the necrotic wall is weakest. Survival depends on immediate surgical repair.

Option by option

  • A. Papillary muscle rupture

    Papillary rupture causes pulmonary oedema, not PEA.

  • B. Pulmonary embolism from DVT

    PE is possible but is less likely than rupture in this timing.

  • C. Left ventricular free wall rupture with tamponade (correct)

    Correct. Tamponade from rupture gives PEA with distended neck veins.

  • D. Recurrent ventricular fibrillation

    VF would show a chaotic rhythm, not an organised one.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Left ventricular free wall rupture with tamponade. Free wall rupture causes haemopericardium and tamponade, producing pulseless electrical activity.

Why is "Papillary muscle rupture" not the answer?

Papillary rupture causes pulmonary oedema, not PEA.

Why is "Pulmonary embolism from DVT" not the answer?

PE is possible but is less likely than rupture in this timing.

Why is "Recurrent ventricular fibrillation" not the answer?

VF would show a chaotic rhythm, not an organised one.

What concept does this question test?

It tests Cardiology: free wall rupture in General Medicine. It typically occurs 3-7 days after a transmural MI when the necrotic wall is weakest. Survival depends on immediate surgical repair.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: free wall rupture?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.