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[Two cases of cardiac rupture after myocardial hemorrhagic infarct]
H Ishibashi-Ueda1, C Yutani, M Imakita
1Department of Pathology, National Cardiovascular Center.
Insights
Hemorrhagic myocardial infarcts, characterized by bleeding in necrotic heart tissue, may increase the risk of cardiac rupture. This finding highlights a potential risk factor for sudden cardiac death in older men.
Area of Science:
- Cardiovascular Pathology
- Clinical Autopsy Studies
Background:
- Sudden cardiac death in elderly men can be attributed to various causes.
- Myocardial infarction (MI) is a common cardiac event, but its complications can vary.
Observation:
- Two male patients over 65 with no prior myocardial infarcts presented with sudden chest pain and died within four days.
- Autopsies revealed transmural myocardial infarcts with central hemorrhage and cardiac rupture.
- Hemorrhagic areas within infarcts showed delayed healing compared to anemic zones.
Findings:
- Cardiac rupture occurred centrally within hemorrhagic myocardial infarcts.
- The presence of hemorrhage in necrotic myocardial tissue was associated with delayed healing.
- Hemorrhagic infarcts appear to be a significant factor in cardiac rupture.
Implications:
- Hemorrhagic myocardial infarction may represent a distinct risk factor for fatal cardiac rupture.
- Understanding infarct characteristics, such as hemorrhage, is crucial for risk stratification.
- Further research into the mechanisms of hemorrhagic infarcts and cardiac rupture is warranted.
Abstract:
Two patients, both of whom were men over 65 years of age who had no history previous myocardial infarcts, had sudden chest pain. One of the men died due to cardiogenic shock on the first day, and the other died on the fourth hospital day. Each autopsy disclosed transmural myocardial infarct with hemorrhage, resulting in cardiac rupture. Hemorrhage was recognized in the necrotic area of the myocardial infarcts. Each cardiac rupture was found in the center of the hemorrhagic infarcts. The ruptures were tear-like slits. The healing process of the infarct was much more delayed in the hemorrhagic area than in the anemic area. These two cases suggest that hemorrhagic infarct may be one of the risk factors of cardiac ruptures.