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Myocardial rupture in expanded infarcts: repair using pericardial patch.
J S Carey1, R A Cukingnan, J Eugene
1Department of Surgery, Little Company of Mary Hospital, Torrance, California.
Clinical Cardiology
|March 1, 1989
Summary
Myocardial rupture, a complication of heart attack, is often fatal due to delayed diagnosis. Early recognition and intervention in patients with post-infarction instability can improve outcomes.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Myocardial rupture complicates approximately 20% of fatal myocardial infarctions.
- Diagnosis is infrequently established antemortem, contributing to high mortality.
Observation:
- Rupture occurs in expanding transmural infarctions.
- Recurrent chest pain and cardiovascular instability within the first week post-infarction warrant consideration of rupture.
- Echocardiography can reveal a dilated infarct with pericardial effusion, aiding diagnosis.
Findings:
- The study reviews three cases and previous reports on myocardial rupture.
- Multivessel disease is common in affected patients.
- Treatment strategies include pericardiocentesis, cardiac catheterization, infarctectomy, and surgical closure of defects.
Implications:
- A high index of suspicion is crucial for timely diagnosis of myocardial rupture.
- Prompt diagnosis and intervention can improve the treatability of myocardial rupture.
- Surgical repair techniques involve dacron-bolstered sutures and autologous pericardial patches.