Diverse presentations of cardiac rupture following acute myocardial infarction

Marina Leitman, Vladimir Shir, Eli Peleg, Simha Rosenblatt, Edgar Sucher, Ricardo Krakover, Edo Kaluski, Zvi Vered

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cardiac rupture is a rare but ominous complication of myocardial infarction. Objectives: To study the clinical presentation, medical course, outcome and echocardiographic predictors of patients with myocardial rupture. Methods: We evaluated 15 consecutive patents with cardiac rupture during a 4 year period in our department. The current report explores the presence of potential risk factors, timing, relation to the thrombolysis, coronary interventions and outcome. Results: The index event in all patients was first ST elevation myocardial infarction. In seven patients rupture occurred in the first 24 hours. Pericardial effusion on admission with a clot was present in three patients. Five patients received thrombolytic therapy. Only three patients underwent coronary angioplasty, but in one case it was performed late and in two patients the culprit artery could not be opened. Six patients reached the operating room, of whom three survived. Conclusions: The lack of early mechanical reperfusion in acute myocardial infarction and thrombolytic therapy are risk factors for cardiac rupture. Pericardial effusion on admission and evidence of a clot are echocardiographic indicators of cardiac rupture and should alert the medical team to further assess the possibility of cardiac rupture.

Original languageEnglish
Pages (from-to)670-672
Number of pages3
JournalIsrael Medical Association Journal
Volume6
Issue number11
StatePublished - Nov 2004

Keywords

  • Cardiac rupture
  • Complication
  • Myocardial infarction

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