Left Ventricular Free Wall Rupture After Acute Myocardial Infarction

pp 395-404

Abstract

Thrombolytic therapy and primary angioplasty have modified the management, evolution and prognosis of acute myocardial infarction; however, mortality from left ventricular free-wall rupture still remains extremely high. The occurrence of this complication is sudden and catastrophic in most patients, and is characterized by cardiac tamponade, electromechanical dissociation and immediate death; however, approximately one third of patients present subacute cardiac rupture with sustained hypotension and pericardial effusion of diverse sizes that allow the implementation of therapeutic measures as a bridge to surgery with repair of the myocardial rupture. In this paper, we provide an update on the clinical and echocardiographic features of patients with left ventricular free-wall rupture complicating an acute myocardial infarction in order to highlight the key diagnostic points and increase the clinical suspect of a severe condition that is not always fatal.