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[Heart rupture as an outcome of myocardial infarct]
Insights
Cardiac rupture occurred in 21.1% of myocardial infarction deaths, primarily in individuals over 60. Early diagnosis of cardiac rupture is possible with characteristic ECG changes, suggesting potential for surgical intervention.
Area of Science:
- Cardiology
- Pathology
Background:
- Myocardial infarction (MI) is a leading cause of death.
- Cardiac rupture is a serious, often fatal, complication of MI.
Observation:
- This study examined 109 deceased patients with myocardial infarction.
- Cardiac rupture was identified in 21.1% of these cases.
- External rupture was more common (21 cases) than internal rupture (2 cases).
Findings:
- Cardiac rupture predominantly affects individuals over 60 years old.
- Extensive transmural infarction was consistently observed in external rupture cases.
- Diagnosis during life was achieved in just over half of the cases.
- Protracted rupture cases exhibited specific clinical signs like persistent pain, shock, and pericardial friction.
- Characteristic electrocardiogram (ECG) changes were identified in protracted rupture cases, aiding in ante-mortem diagnosis.
Implications:
- Early identification of cardiac rupture, particularly protracted forms, is crucial.
- The findings suggest that surgical intervention may be a viable option for patients with protracted cardiac rupture.
- Further research into surgical techniques for cardiac rupture is warranted.
Abstract:
The authors studied the incidence and character of cardiac rupture in 109 deceased of myocardial infarction. Rupture was encountered in 21.1 per cent. Out of the 23 ruptures -- 21 were external and 2 -- internal at the intraventricular septum. Cardiac rupture is an occurence mainly in subjects over 60. Extensive transmural infarction was diagnosed in all cases of external rupture. The diagnosis was made while still alive in a little more than a half of the cases. In seven of the cases, the external rupture was with a protracted progress with the following clinical manifestations -- preceeding strong, refractory, continuous pain and anxiety, protracted shock state, prolonged pericardial friction. Characteristic ECG changes are described in case of protracted ruptures enabling the admittance of the rupture while still living. The authors express the opinion that in cases with protracted rupture, surgical life-saving intervention is possible.