Mechanical complications of acute myocardial infarction

Abstract

Mechanical complications of myocardial infarction include: left ventricular free wall rupture, ventricuiar septal rupture and acute mitral incompetence caused by rupture of papillary muscle. These comorbidities are rare but still with high mortality. There are some risk factors of the cardiac rupture known from the literature, such as female gender, age more than 60 years, hypertension, first myocardial infarction and persistent chest pain. In the most cases cardiac rupture in acute myocardial infarction occurs in the period of 21 days from admission. Among examination methods, transthoracic echocardiography is crucial to confirm cardiac rupture. The prevention of the cardiac rupture in acute myocardial infarction consists of the optimal pharmacotherapy to reduce the chest pain and to maintain the systolic blood pressure below 120 mmHg, applying betaadrenolytics and angiotensin-converting enzyme inhibitors (ACEI). ESC and ACC/AHA recommend the urgent surgical repair as the treatment of choice in cardiac rupture. Copyright © 2006 Almamedia.