[Mechanical complications due to ischemic damage after an acute myocardial infarct]

Three patients, two women aged 61 and 60 years and one man aged 78 years, who had sustained a myocardial infarction shortly before, developed acute dyspnoea, shock and (or) chest pain, and a holosystolic souffle. They suffered from rupture of the interventricular septum, acute mitral valve incompetence due to rupture of the papillary muscles, and rupture of the free wall of the ventricle, and died in spite of attempts at surgical repair. In these relatively infrequent mechanical complications of myocardial infarction the interval between the initial myocardial infarction and the onset of dyspnoea or profound shock is characteristic. With the current thrombolytic therapy and beta-blockade, reduction of the mechanical complications of myocardial infarction is possible, in particular of rupture of the free wall of the ventricle.