[External heart rupture in myocardial infarct (clinical picture, prospects for resuscitation)]

An analysis is presented on 53 cases of external ruptures of the heart in cases of transmural myocardial infarction. Most of the patients were above 60 years of age, with a hypertensive syndrome, with intensive, protracted, often recurring cardiac and retrosternal pains. The pains were interpreted as the manifestation of myocardial rupture. Blood tests revealed a high leucocytosis, an elevated level of lactate dehydrogenase and catecholamines excretion, mainly at the expense of noradrenaline, as well as an increased amount of serotonin, histamine, magnesium salts. A sudden onset of a catastrophic deterioration in the form of a cardiogenic shock was interpreted as a partial rupture with a progressively increasing penetrating rupture; clinical death with a preserved electrical activity of the heart--as its complete rupture. Cases of temporary efficieny resuscitation with a survival period in some cases of as long as 3 days are presented. The authors believe it possible to foresee a myocardial rupture, to diagnose it before the electrical activity of the heart ceases, to maintain the life of the patient so as to permit a cardiac surgical team to undertake an operative procedure.