Ventricular free wall rupture following acute myocardial infarction.
Ventricular free wall rupture remains a dreaded complication of acute myocardial infarction. A dramatic fatal presentation is not universal and if recognized early, especially in its sub-acute form, a therapeutic intervention may be lifesaving. Changing trends in its natural history and the previously described pathological subtypes have emerged since the advent of thrombolysis. Although frequently unpredictable, certain clinical, echocardiographic and electrocardiographic signs should suggest the diagnosis. Moreover, knowledge of predisposing risk factors and a high index of suspicion are helpful in early recognition of this complication. In recent years, several different therapeutic approaches have been described including percutaneous seals and surgical mechanical closure of ventricular free wall rupture. In this review, we sought to highlight established and debatable aspects of this pathology to hopefully enhance prompt diagnosis and treatment by all clinicians caring for patients suffering acute myocardial infarction.
Birnbaum
Yochai
Y
Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, 5106 John Sealy Annex, 301 University Boulevard, Galveston, TX 77555-0553, USA. yobirnba@utmb.edu
Chamoun
Antonio J
AJ
Anzuini
Angelo
A
Lick
Scott D
SD
Ahmad
Masood
M
Uretsky
Barry F
BF
D017541:Aneurysm, False / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006342:Heart Rupture, Post-Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D015994:Incidence; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy