UMEM Educational Pearls

Predictors of Cardiac Rupture After AMI

- In the era of revascularization and aggressive cardiac care there has been a continual decline in acute myocardial infarction (AMI) mortality rates; however one of the most deadly complications, cardiac rupture (left ventricular free wall, ventricular septum, or papillary muscle rupture), still remains relatively stable.

- Cardiac rupture is an increasingly more frequent cause of death during AMI, thus a recent study retrospectively assessed the clinical and morphologic variables in those with and without cardiac rupture that were hospitalized for AMI.

- Cardiac rupture overwhelmingly complicates a first AMI.

- Cardiac rupture occurs most often in patients with an immense quantity of cardiac adipose tissue, the size of the left ventricular cavity is typically normal, and the area of the infarct is small.

- Heart failure patients with prior AMI have healed scar tissue and are at nominal risk of complications such as rupture if a subsequent AMI occurs.  

References

Roberts W, et al. Commonalities of Cardiac Rupture (Left Ventricular Free Wall or Ventricular Septum or Papillary Muscle) During Acute Myocardial Infarction Secondary to Atherosclerotic Coronary Artery Disease. The American Journal of Cardiology. Volume 115, Issue 1, Pages 125-140 (1 January 2015).