Myocardial rupture after myocardial infarction

Detection by multi-gated image-acquisition scintigraphy
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      Myocardial rupture following infarction usually is an acute and dramatic event. Rarely, it may take a subacute course, allowing surgical treatment. We report herein a case of subacute rupture of the heart in a 54 year old patient with acute myocardial infarction. The rupture was diagnosed by the appearance of a radiopaque halo around the heart during radionuclide ventriculography. The patient subsequently underwent surgical resection of a large anterolateral aneurysm and a 2 inch long rupture of the myocardium and survived. Clinical suspicion, prompt diagnosis, and surgical intervention are important in the management of this relatively unusual complication of infarction.
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        • Lewis J
        • Burchell HB
        • Titus JL
        Clinical and pathological features of post infarction rupture.
        Am J Cardiol. 1969; 23: 43-53
        • Van Tassel RA
        • Edwards J
        Rupture of the heart complicating myocardial infarction. Analysis of 40 cases including nine examples of left ventricular aneurysm.
        Chest. 1972; 61: 104-116
        • Sigler LH
        Sudden death due to cardiac rupture in myocardial ischemia and infarction. Causes, mechanism, and possible prevention.
        NY State J Med. 1969; 69: 794-799
        • Naeim F
        • de La Maza LM
        • Robbins SL
        Cardiac rupture during myocardial infarction: a review of 44 cases.
        Circulation. 1972; 45: 1231-1239
        • Krumbhaar EB
        • Crowell C
        Spontaneous rupture of the heart.
        Am J Med Sci. 1925; 170: 828-856
        • Lautsch EV
        • Lanks KW
        Pathogenesis of cardiac rupture.
        Arch Pathol. 1967; 84: 264-271
        • Griffith GC
        • Balakrishna H
        • Oblath RW
        Factors in myocardial rupture. An analysis of two hundred and four cases at Los Angeles County Hospital between 1924 and 1959.
        Am J Cardiol. 1961; 8: 792-798
        • London RE
        • London SB
        Rupture of the heart. A critical analysis of 47 consecutive autopsy cases.
        Circulation. 1965; 31: 202-208
        • Edmonson HA
        • Hoxie HJ
        Hypertension and cardiac rupture. A clinical and pathologic study of seventy-two cases in thirteen of which rupture of the interventricular septum occurred.
        Am Heart J. 1942; 24: 719-733
        • Ersek RA
        • Chesler E
        • Korns ME
        • Edwards J
        Spontaneous rupture of a false left ventricular aneurysm following myocardial infarction.
        Am Heart J. 1969; 77: 677-680
        • Gobel FL
        • Visudh-Arom K
        • Edwards JE
        Pseudoaneurysm of the left ventricle leading to recurrent pericardial hemorrhage.
        Chest. 1971; 59: 23-27
        • Chesler E
        • Korns ME
        • Semba T
        • Edwards JE
        False aneurysms of the left ventricle following myocardial infarction.
        Am J Cardiol. 1969; 23: 76-82
        • Hurst CO
        • Fine G
        • Keyes JW
        Pseudoaneurysm of the heart. Report of a case and review of the literature.
        Circulation. 1963; 28: 427-436
        • Roberts WC
        • Morrow AG
        Pseudoaneurysm of the left ventricle. An unusual sequel of myocardial infarction and rupture of the heart.
        Am J Med. 1967; 43: 639-644
        • Biörck G
        • Mogensen L
        • Nyquist O
        • Orinius E
        • Sjögren A
        Studies of myocardial ruptures with cardiac tamponade in myocardial infarction. I. Clinical features.
        Chest. 1972; 61: 4-13
        • Couzinier JP
        • Guerinon J
        • Diallo A
        • Soulie J
        • Grivaux M
        Les ruptures myocardiques en péricarde libre à la période aigue d'un infarctus du myocarde.
        Sem Hop Paris. 1974; 50: 3191-3200
        • Bates RJ
        • Beutler S
        • Resnekov L
        • Anagnostopoulos CE
        Cardiac rupture. Challenge in diagnosis and management.
        Am J Cardiol. 1977; 40: 429-437
        • Lillehei WC
        • Laude TJ
        • Rassman WR
        • Tanaka S
        • Bloch JH
        Surgical management of myocardial infarction. Some promising concepts utilizing revascularization, mechanical circulatory assistance, operative treatment of severe complications and cardiac replacement.
        Circulation. 1969; 39 and 40: 315-319
        • Lampesis PT
        • Crandall WD
        • King SJ
        Ruptured myocardial infarction with survival for three weeks.
        N Engl J Med. 1953; 248: 455-457
        • Fitzgibbon GM
        • Hooper GD
        • Heggtveit HA
        Successful surgical treatment of post infarction external cardiac rupture.
        J Thorac Cardiovasc Surg. 1972; 63: 622-630
        • Kendall RW
        • DeWood MA
        Post infarction cardiac rupture: surgical success and review of the literature.
        Ann Thorac Surg. 1978; 25: 311-315
        • Eisenmann B
        • Bareiss P
        • Pacifico AD
        • et al.
        Anatomic, clinical, and therapeutic features of acute cardiac rupture. Successful surgical management fourteen hours after myocardial infarction.
        J Thorac Cardiovasc Surg. 1978; 76: 78-82
        • O'Rourke MF
        Subacute heart rupture following myocardial infarction. Clinical features of a correctable condition.
        Lancet. 1973; II: 124
        • Cobbs BW
        • Hatcher CR
        • Robinson PH
        Cardiac rupture. Three operations with two long-term survivals.
        JAMA. 1973; 223: 532-535
        • Dehmer GJ
        • Lewis SE
        • Hillis LD
        • et al.
        Nongeometric determination of left ventricular volumes from equilibrium blood pool scans.
        Am J Cardiol. 1980; 45: 293-300
        • Rejali AM
        • MacIntyre WT
        • Friedell HL
        A radioisotope method of visualization of blood pools.
        Am J Roentgenol. 1958; 79: 129-137
        • Wagner HN
        • MacAfee JG
        • Mozley JM
        Diagnosis of pericardial effusion by radioisotope scanning.
        Arch Intern Med. 1961; 108: 679-684
        • Uren RF
        • McLaughlin AF
        • Cormack J
        Cardiac tamponade: accurate diagnosis by radionuclide angiography.
        Aust NZ J Med. 1980; 10: 414-420