Archivo Médico de Camagüey (Jun 2019)

Myocardial rupture of left ventricle secondary to myocardial infarction

  • Alberto José Piamo-Morales,
  • Daisy Ferrer-Marrero,
  • Lourdes Palma-Machado,
  • Isnerio Arzuaga-Anderson,
  • Digna Chávez-Jiménez,
  • Mayra Afrodita García-Rojas

Journal volume & issue
Vol. 23, no. 3
pp. 349 – 360

Abstract

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Background: myocardial rupture is a rare complication of acute myocardial infarction with an overall incidence of around 6.2 %. Objective: to characterize the deaths due to acute myocardial infarction with the rupture of the left ventricle wall. Methods: a retrospective, descriptive and observational study was carried out in which the deceased were analyzed with a diagnosis of direct cause of death: cardiac tamponade due to hemopericardium, myocardial rupture and acute myocardial infarction. Results: of 877 acute myocardial infarcts diagnosed between 2010 and 2018, 16 of them had myocardial wall rupture of which 68.8% were male. The habit of smoking was the predominant risk factor. Only in 35.7 % the correct clinical diagnosis of AMI was made and in none of the cases was the diagnosis of myocardial rupture or cardiac tamponade due to hemopericardium. The anatomical region of the heart where myocardial ruptures were most frequently located was in the posterior wall. Conclusions: rupture of the myocardial wall is a rare but catastrophic complication of infarction with a high mortality, however, this can be reduced if the clinical picture is suspected, and an early diagnosis is made with the introduction of support measures to maintain hemodynamic stability. DeCS: MYOCARDIAL INFARCTION/diagnosis; MYOCARDIAL INFARCTION/mortality; HEART RUPTURE, POST-INFARCTION/complications; CARDIAC TAMPONADE; SMOKING.

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