Cardiac rupture as a complication of acute myocardial infarction

Abstract

Introduction: The main causes of death in patients with myocardial infarction are cardiac arrhythmias and mechanical complications. Within them, cardiac rupture causes a severe hemodynamic compromise with a high mortality rate.

Objective: To characterize patients who died of cardiac rupture as a complication of acute myocardial infarction.

Method: A descriptive, cross-sectional study at the Arnaldo Milián Castro University Hospital in Santa Clara, Cuba, between 2010 and 2014. All patients who died with a clinical diagnosis of acute myocardial infarction, who underwent autopsy and were confirmed a cardiac rupture, were studied.

Results: There were prevalence of female sex (53.2%), advanced age (more than 75 years), smoking (64.5%), hypertension (61.3%), and absence of angina (96.8%). 43 patients (69.4%) did not undergo thrombolysis, 31 of them (72.1%) had an atypical infarction presentation. Left ventricular free wall rupture (91.9%) was the most frequent. Cardiac tamponade was identified in 80.7% of the patients and cardiogenic shock in 17.7%. Almost half of those who had free wall rupture (47.3%) had an extensive extensive anterior wall myocardial infarction.

Conclusions: Female patients over 75 years old, with smoking, hypertension and diabetes mellitus predominated. Most of the patients did not have previous angina, did not receive thrombolytic treatment, and showed atypical clinical presentation. Free wall rupture was the most frequent, and almost half of those who suffered it had an extensive anterior wall myocardial infarction.