Left ventricular free wall rupture after reperfusion therapy for acute myocardial infarction

Sugiura, Tetsuro; Nagahama, Yo; Nakamura, Shinya; Kudo, Yoshihisa; Yamasaki, Fumiyasu; Iwasaka, Toshiji

doi:10.1016/s0002-9149(03)00625-8

Cited by 26 publications

(22 citation statements)

References 17 publications

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“…Importantly, 8% died suddenly of a likely FWR (CTϩEMD); similar cases have been previously documented. 1,15,31 This incidence of CT was higher than that reported for STEMI patients in general (0.9% to 2%). 20,[22][23][24][25] Unfortunately, however, no specific features allowed identification of those patients who finally developed CT other than it was a late event.…”

Section: Management and Outcomecontrasting

confidence: 55%

“…Moreover, the 8 patients who evolved to CT all died of EMD. Similarly, Sugiura et al 15 have recently reported that 6 of 13 patients (46%) who died of FWR had shown an MPE without CT before the fatal event.…”

Section: Mpe Without Initial Ctmentioning

confidence: 74%

“…Therefore, these results would lend support to the feasibility of medical management in some selected patients, 13 also reported by others. 12,15,26,30 Our results, however, are subject to the concept of "confounding by indications" because surgery versus medical therapy was selected in part on the basis of the patient's clinical profile and prognosis. Hence, it is difficult to distinguish how much of the treatment difference in outcomes was due to treatment per se as opposed to the patient profile.…”

Section: Management and Outcomementioning

confidence: 99%

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Hospital Outcome of Moderate to Severe Pericardial Effusion Complicating ST-Elevation Acute Myocardial Infarction

et al. 2010

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Background-Hospital prognosis of moderate to severe pericardial effusion (MPE; Ն10 mm) in ST-elevation myocardial infarction is largely unknown. Methods and Results-Data from 446 ST-elevation myocardial infarction patients, 228 with MPE-88 with cardiac tamponade (CT) and electromechanical dissociation (EMD), 44 with CT without EMD (w/oEMD), and 96 without initial CT-and 218 with small PE (5 to 9 mm), were compared. Patients with MPE without initial CT were also compared with 96 patients without PE. CT patients showed larger PE (PϽ0.001) than those without initial CT; 85% of those with CTϩEMD and 86% with CTw/oEMD were treated with pericardiocentesis and 10% and 21% were treated with a surgical repair, respectively. Among MPE patients, 30-day mortality was 43% and was higher in those with CTϩEMD (operated, 89%; and nonoperated, 85%) than in those with CTw/oEMD (22% and 11%, respectively; PϽ0.001) and those without initial CT (17%; PϽ0.001). It was also higher than in patients with small PE (10%; PϽ0.001) or those without PE (6%; Pϭ0.001). Death was attributable to cardiac rupture in 83% of patients with CTϩEMD, 7% with CTw/oEMD, and 8% with MPE without initial CT and occurred late (Ն7 days) in 14%, 67%, and 100%, respectively. Conclusions-MPE carries an increased mortality that is highest in patients with CTϩEMD. In those with CTw/oEMD, however, mortality is considerably low after pericardiocentesis, and subsequent management may be individualized because a conservative approach is often successful. Importantly, MPE patients without initial CT are not free from late rupture and deserve further investigation.

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Section: Management and Outcomecontrasting

confidence: 55%

Section: Mpe Without Initial Ctmentioning

confidence: 74%

Section: Management and Outcomementioning

confidence: 99%

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Hospital Outcome of Moderate to Severe Pericardial Effusion Complicating ST-Elevation Acute Myocardial Infarction

et al. 2010

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“…A papillary muscle rupture often accompanies the right or circumflex coronary artery closure and results in an acute mitral regurgitation (MR) manifested as pulmonary oedema or CS. The treatment of choice in all cases mentioned is an immediate surgical intervention because the mortality in patients treated conservatively reaches 90% [18][19][20].…”

Section: Mechanical Complications Of Myocardial Infarctionmentioning

confidence: 99%

The management of patients with cardiogenic shock

Sadowski¹,

Janion−Sadowska²

2017

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Cardiogenic shock is a life-threatening condition with a very poor prognosis. Many disorders may contribute to the development of shock. Of them, acute myocardial infarction is the main culprit. Despite tremendous progress in the field of interventional cardiology, in-hospital and long-term mortality still exceeds 50%. Data from large controlled trials on cardiogenic shock are scarce due to ethical reasons. Nevertheless, there is a chance for acceptable long-term survival in patients treated aggressively. The aim of this review is to summarise the key points of differential diagnosis and to emphasise that in most cases of shock due to acute myocardial infarction primary coronary intervention is the treatment of choice. StreszczenieWstrząs kardiogenny jest stanem zagrożenia życia o bardzo złym rokowaniu. Wiele sytuacji klinicznych przyczynia się do rozwoju wstrząsu, ale ostry zawał serca stanowi najczęstszą przyczynę. Pomimo olbrzymiego postępu w kardiologii interwencyjnej śmiertelność szpitalna i długoterminowa nadal przekracza 50%. Z powodów etycznych nie dysponujemy danymi z kontrolowanych badań klinicznych. Niemniej agresywne leczenie stwarza szansę na uzyskanie akceptowalnego poziomu śmier-telności w tej grupie chorych. Celem pracy jest próba podsumowania najważniejszych elementów diagnostyki różnicowej oraz wykazanie, że pilna rewaskularyzacja za pomocą angioplastyki wieńcowej jest leczeniem z wyboru w większości przypadków.

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“…Free wall rupture occurs in approximately 5% (according to different Authors 4-8%) [5], over 10% in patients who died in the hospital by STEMI [6]. On the other hand, the right ventricular rupture is described as a rare complication after myocardial infarction [7] and only a few cases were reported [8].…”

Section: Introductionmentioning

confidence: 99%