[A case of combined internal and external rupture of an enlarged right heart ventricle]

A rare case of successive development of internal and external rhexis of the right ventricle of the heart in myocardial infarction in a man of 50 is presented. The myocardial infarction had been preceded by chronic pulmonary diseases which resulted in the development of the pulmonary heart and chronic pulmonary-cardiac deficiency. The death was due to cardiac tamponade in connection with external cardiorhexis. Clinical and macroscopic changes in the zone of the right ventricle papillary muscle rhexis did not correspond to microscopic changes typical of this stage of infarction which the authors believe to be associated with long-term corticosteroid therapy. The lack of the signs of marked coronary sclerosis suggests that myocardial infarction of the right ventricle was due to severe hypoxia of the functionally overstrained myocardium.