Cardiogenic shock due to cardiac free-wall rupture or tamponade after acute myocardial infarction: a report from the SHOCK Trial Registry

Slater, James; Brown, Robert; Antonelli, Tracy A.; Menon, Venu; Boland, Jean; Col, Jacques; Džavík, Vladimir; Greenberg, Mark A.; Menegus, Mark; Connery, Cliff P.; Hochman, Judith S.

doi:10.1016/s0735-1097(00)00845-7

Cited by 160 publications

(101 citation statements)

References 25 publications

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“…354 Mechanical complications after AMI are associated with high mortality rates and usually require urgent surgical intervention. 354,[373][374][375] Women are at a higher risk of developing mechanical complications after MI, but sex-specific data on treatment are sparse.…”

Section: Mechanical Complicationsmentioning

confidence: 99%

“…[382][383][384] Older age, anterior AMI, and delayed thrombolysis are additional risk factors. 374,382,383,385 Primary PCI is protective against free wall rupture, likely because of the reduction in hemorrhagic transformation of the infarcted myocardium. 384 Although the incidence of free wall rupture is low, complicating <1% of AMI and representing 1.4% of AMI-associated CS, it carries a 55% to 60% mortality rate and is the second most common cause of death after left ventricular pump failure following AMI.…”

Section: Mechanical Complicationsmentioning

confidence: 99%

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Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

901

393

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Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

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Section: Mechanical Complicationsmentioning

confidence: 99%

Section: Mechanical Complicationsmentioning

confidence: 99%

Acute Myocardial Infarction in Women

Mehta¹,

Beckie²,

DeVon³

et al. 2016

Circulation

901

393

View full text Add to dashboard Cite

show abstract

“…30,34 Whether the inferior myocardial wall is more prone to rupture is controversial. 36,37 Diagnosis should be based on the detection of sudden development of pericardial effusion. Of note, in 1 patient mild pericardial effusion was seen on the rest echocardiogram.…”

Section: Cardiac Rupturementioning

confidence: 99%

“…All patients with cardiac rupture had a recent inferior MI, although whether this particular myocardial region is relatively susceptible for rupture is controversial. 36,37 Ventricular fibrillation occurred almost exclusively in patients with impaired LV function with induction of extensive myocardial ischemia. Identification of patients at relatively high risk for acute MI may be more difficult.…”

Section: Identification Of High-risk Patientsmentioning

confidence: 99%

“…Les sujets ayant présenté une rupture cardiaque avaient tous des antécédents récents d'IDM de siège inférieur, ce qui est à prendre en considération même si l'éventuelle prédisposition particulière de cette zone myocardique à la rupture continue à faire débat. 36,37 Les fibrillations ventriculaires ont été presque exclusivement observées chez des patients qui présentaient une dysfonction VG responsable d'une ischémie myocardique étendue. Le dépistage des patients exposés à un risque d'IDM aigu relativement élevé peut être plus délicat.…”

Section: Identification Des Patients à Haut Risqueunclassified

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Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

et al. 2010

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Mechanical Complications of Acute Myocardial Infarction

et al. 2021

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eperfusion therapies have led to a substantial reduction in the frequency of mechanical complications of acute myocardial infarction (MI). 1,2 Recent studies estimate that following ST-elevation MI, 0.27% to 0.91% of patients develop mechanical complications; papillary muscle rupture (PMR), ventricular free-wall rupture (FWR), and ventricular septal rupture (VSR) are estimated to occur in 0.05% to 0.26% of patients, 0.01% to 0.52% of patients, and 0.17% to 0.21% of patients, respectively. 3,4 However, unfortunately, there has been no significant decrease in associated mortality rates over the past 2 decades, and patients with mechanical complications are more than 4-fold more likely to experience in-hospital mortality than those without mechanical complications. 1,3 Mechanical complications are therefore infrequent but remain an important determinant of outcomes after MI. The purpose of this review is to highlight key clinical and diagnostic findings that may assist in the early diagnosis of mechanical complications and present an update on current management strategies. FWR Clinical FeaturesThree morphologies of FWR were originally described as follows: type 1 rupture is an abrupt tear usually within the first 24 hours of MI, type 2 rupture is a slower tear with localized myocardial erosion, and type 3 rupture is a thin-walled aneurysm perforation, which usually occurs more than 7 days after MI. 5 FWR usually occurs within 7 days after MI, 6 with a mean time to diagnosis of 2.6 days in a 2018 series. 7 Early autopsy studies demonstrated that an abrupt large tear would likely lead to sudden cardiac tamponade, cardiogenic shock, and cardiac arrest, whereas a smaller, more gradual tear may be limited by thrombus formation or a compliant pericardium but with hemodynamic instability and pericardial effusion. 8 These 2 types are also described in the surgical literature as the blowout and oozing types, respectively. 7,9 In the SHOCK trial registry, 10 there was no significant sex difference in the incidence of FWR, but patients with FWR were less likely to have diabetes or a history of prior MI. It is postulated that the absence of certain cardiovascular risk factors denotes individuals who are less likely to have coronary artery disease and thus less likely to have developed collateral circulations that protect the myocardium in the setting of acute vessel occlusion.Patients with FWR may present with chest pain, restlessness, hemodynamic compromise, or cardiogenic shock (Table ). In a 2018 series, 7 more than 80% of patients presented with cardiac tamponade. FWR occurring late in the first week or beyond may also be associated with a history of straining, such as with coughing or vomiting. 11 Examination findings may be significant for a raised jugular venous IMPORTANCE Mechanical complications of acute myocardial infarction include left ventricular free-wall rupture, ventricular septal rupture, papillary muscle rupture, pseudoaneurysm, and true aneurysm. With the introduction of early reperfusion therapies, these co...

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Cardiogenic shock due to cardiac free-wall rupture or tamponade after acute myocardial infarction: a report from the SHOCK Trial Registry

Abstract: Free-wall rupture and tamponade may present as CS after MI, and survival after intervention is similar to that of the overall shock cohort. All patients with CS after MI should have echocardiography in order to detect subacute rupture or tamponade and initiate appropriate interventions.

Cited by 160 publications

References 25 publications

Acute Myocardial Infarction in Women

Acute Myocardial Infarction in Women

Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

Mechanical Complications of Acute Myocardial Infarction

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