Studies of Myocardial Rupture with Cardiac Tamponade in Acute Myocardial Infarction

I. Clinical Features

¹ Department of Medicine, Karolinska Institutet at Serafimerlasarettet, Stockholm, Sweden

The clinical features of cardiac rupture with tamponade in acute myocardial infarction have been studied in an attempt to predict this complication and find clues to prophylactic and therapeutic measures. Eleven cases with rupture of the free left ventricular wall in a consecutive series of 529 coronary care unit (CCU) patients with acute myocardial infarction have been analyzed. These 11 patients accounted for 10 percent of the mortality. The significant features were absence of a history of previous myocardial infarction in association with electrocardiographic (ECG) signs of acute infarction present at time of admission. In no instance was the infarct purely inferior in its location. These characteristics would have given 0.2 percent false negative and 17 percent false positive prediction among these 529 patients with acute myocardial infarction. In seven of the patients the rupture occurred during the first day of the illness. In no case did the rupture occur in massive infarction, which provides a basis for hope of success following surgical intervention in the future.

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