Related Experiment Video
Updated: Dec 31, 2025
Generation and Characterization of Right Ventricular Myocardial Infarction Induced by Permanent Ligation of the Right Coronary Artery in Mice
Published on: February 1, 2022
Left ventricular free wall rupture in myocardial infarction: A retrospective analysis from a single tertiary center
Swaroop Varghese1, Marc-Alexander Ohlow2
1Department of Cardiology, Harzklinikum, Wernigerode, Germany.
Objective:
Left ventricular free wall rupture (LVFWR) is a rare but severe complication of acute myocardial infarction (AMI). During the era of pre-thrombolysis, autopsies revealed an incidence of approximately 8%.
Method:
The objective of this retrospective study was to analyze the current incidence of LVFWR and to identify predictors by comparing the AMI-cohort with LVFWR to those without. The control group involved a random selection of one in every ten patients who presented with acute myocardial infarction between 2005 and 2014.
Result:
A total of 5143 patients with AMI were treated at the Central Hospital, Bad Berka (71% men, median age 68 years). Out of these, seven patients with LVFWR were identified with an overall incidence of 0.14%. Clinically, LVFWR patients presented late to admission since symptom onset (median 24 h vs. 6.1 h; p < 0.0001), were more likely in cardiogenic shock (28.6% vs. 3.2%; p = 0.02) and were usually accompanied by emergency physicians (71.4% vs. 20.7%; p = 0.006). Higher troponin T (median 8.6 vs. 0.5 ng/ml; p < 0.0002), higher CRP (median 50 vs. 0.5 mg/l; p = 0.05) as well as a lower hematocrit-values (0.33 vs. 0.42; p = 0.04) were observed. All LVFWR patients were operated (100% vs. 1.6%; p < 0.001). The patients had lower rates of beta-blocker treatment (57.1% vs. 95.8%; p = 0.003). The 30-day mortality was significantly higher (42.9% vs. 6.8%; p = 0.01).
Conclusion:
Compared to the thrombolytic era, the current incidence of LVFWR with AMI, who reach the hospital alive, is significantly lower. However, 30-day mortality continues to be high.
Insights
Left ventricular free wall rupture (LVFWR) is a rare complication of acute myocardial infarction (AMI). Current incidence is significantly lower than in the past, but 30-day mortality remains high.
Area of Science:
- Cardiology
- Cardiovascular Research
- Medical Complications
Background:
- Left ventricular free wall rupture (LVFWR) is a critical complication of acute myocardial infarction (AMI).
- Historically, pre-thrombolysis era autopsies showed an LVFWR incidence of approximately 8%.
Purpose of the Study:
- To determine the current incidence of LVFWR in acute myocardial infarction (AMI) patients.
- To identify clinical predictors of LVFWR by comparing patients with and without LVFWR.
Main Methods:
- Retrospective analysis of 5143 AMI patients treated between 2005 and 2014.
- Comparison of clinical characteristics, laboratory values, and treatment between seven LVFWR patients and a control group.
Main Results:
- The current incidence of LVFWR is 0.14%, significantly lower than historical rates.
- LVFWR patients presented later, had higher troponin T and CRP, lower hematocrit, and were more likely to be in cardiogenic shock.
- All LVFWR patients underwent surgery, had lower beta-blocker use, and a significantly higher 30-day mortality (42.9% vs. 6.8%).
Conclusions:
- The incidence of LVFWR among hospitalized AMI patients has substantially decreased.
- Despite advancements, LVFWR remains associated with high in-hospital mortality, underscoring the need for early detection and intervention.
