Cardiac Rupture Complicating Acute and Subacute Myocardial Infarction at Forensic Autopsy

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine

Background:

• Cardiac rupture is a feared complication of myocardial infarction, despite decreased incidence.
• Early identification of high-risk individuals and modifiable risk factors is crucial for improving outcomes.

Purpose of the Study:

• To identify risk factors and characteristics of patients experiencing cardiac rupture post-myocardial infarction using autopsy data.
• To compare rupture cases with non-rupture cases to understand differences in patient demographics and pathology.

Main Methods:

• Retrospective review of 288 autopsies for myocardial infarction cases between 2010 and 2024.
• Comparison of demographic, clinical history, and autopsy findings between cardiac rupture and non-rupture groups.

Main Results:

• 22% of myocardial infarction cases (63/288) were complicated by cardiac rupture.
• Patients with cardiac rupture were more likely to be White, older, and less likely to show cardiomegaly, myocardial fibrosis, or have a history of diabetes mellitus.
• The study group exhibited a higher cardiac rupture rate and longer preceding symptom duration than previously reported.

Conclusions:

• Cardiac rupture in myocardial infarction may present differently than previously understood, with specific demographic and pathological profiles.
• Further research is needed to elucidate the mechanisms and refine early detection strategies for cardiac rupture.