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Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Introduction Cardiac Emergencies01:30

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Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Troponins
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Myocarditis I: Introduction01:21

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Updated: Jan 9, 2026

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Characteristics and Outcomes of Cardiac Rupture in Patients With ST-Segment Elevation Myocardial Infarction.

Kensaku Nishihira1, Satoshi Honda2, Misa Takegami3

  • 1Department of Cardiology, Miyazaki Medical Association Hospital Miyazaki Japan.

Circulation Reports
|December 11, 2025
PubMed
Summary

Cardiac rupture (CR) after ST-segment elevation myocardial infarction (STEMI) is rare but serious. Delayed hospital admission significantly increases CR risk and leads to poor patient outcomes.

Keywords:
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Area of Science:

  • Cardiology
  • Acute Myocardial Infarction Research
  • Clinical Outcomes

Background:

  • Cardiac rupture (CR) is a critical complication of ST-segment elevation myocardial infarction (STEMI).
  • CR includes free wall rupture and ventricular septal rupture.
  • Understanding CR incidence and outcomes in STEMI is vital.

Purpose of the Study:

  • To determine the incidence and characteristics of CR in STEMI patients.
  • To investigate the clinical outcomes associated with CR.
  • To identify risk factors for CR in STEMI.

Main Methods:

  • Analysis of data from the Japan Acute Myocardial Infarction Registry (JAMIR).
  • Inclusion of 2,626 STEMI patients hospitalized between 2015 and 2017.
  • Evaluation of CR incidence, types, and 1-year clinical endpoints.

Main Results:

  • CR occurred in 1.3% of STEMI patients (34/2626).
  • Free wall rupture (73.5%) was more common than ventricular septal rupture (23.5%).
  • CR patients had significantly higher 1-year cardiovascular death, MI, or stroke rates (64.7% vs. 7.9%).
  • Older age, anterior MI, and longer onset-to-admission times were associated with CR.
  • CR incidence increased with longer onset-to-admission times (P<0.001).

Conclusions:

  • Cardiac rupture following STEMI is linked to delayed onset-to-admission.
  • CR significantly worsens clinical outcomes in STEMI patients.
  • Prompt STEMI treatment may mitigate CR risk.