Clinical manifestation of early phase left ventricular rupture complicating acute myocardial infarction in the primary PCI era

Nozoe, Masatusugu; Sakamoto, Tomohiro; Taguchi, Eiji; Miyamoto, Shinzou; Fukunaga, Takashi; Nakao, Kōichi

doi:10.1016/j.jjcc.2013.06.012

Cited by 32 publications

(37 citation statements)

References 24 publications

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“…Likewise for infarction involving the LAD, pooled OR remained >1 after each study was removed, although p values became borderline non-significant with removal of Ptaszyńska-Kopczyńska et al 8 and Katayama et al ,16 and became non-significant with removal of Nozoe et al ,5 Ledakowicz-Polak et al ,20 Yip et al ,18 and Crenshaw et al 22. Therefore, pooled estimates for LAD involvement might be affected by these 4 studies (online supplementary table 1).…”

Section: Resultsmentioning

confidence: 94%

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Hao

Guo

et al. 2019

Journal of Investigative Medicine

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Cardiac rupture (CR) is a complication of acute myocardial infarction (AMI) that is associated with a high mortality rate. This study aimed to identify the risk factors for CR in patients with AMI. Medline, Cochrane, EMBASE, and Google Scholar databases were searched for relevant literature published through September 16, 2018. Eligible studies included patients with AMI and compared factors between patients with and without CR. Sixteen studies were identified and included in the meta-analysis. Results revealed that female gender (pooled OR=2.72, 95% CI 2.04 to 3.63, p<0.001), older age (pooled difference in means=6.91, 95% CI 4.20 to 9.62, p<0.001), infarction at left anterior descending coronary artery (LAD) (pooled OR=1.85, 95% CI 1.03 to 3.32, p=0.039), and anterior wall infarction (pooled OR=1.87, 95% CI 1.30 to 2.68, p=0.001) were associated with increased risk of CR, whereas history of MI, smoking, and multivessel disease were associated with reduced risk of CR. Patients treated with primary percutaneous coronary intervention (PCI) had reduced risk of CR, while patients who had received any thrombolysis had increased risk of CR. In conclusion, results of systematic review and meta-analysis of existing literature suggest that risk factors for CR in patients with AMI include female gender, older age, new-onset MI, non-smoking status, LAD infarction, anterior wall infarction, and single-vessel disease. Furthermore, treatment with primary PCI may help reduce the risk for CR, while thrombolysis might increase the risk for CR.

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Section: Resultsmentioning

confidence: 94%

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Hao

Guo

et al. 2019

Journal of Investigative Medicine

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“…First, although current guidelines by the American Heart Association merely define within 2 days of acute myocardial as the absolute contraindication for performing exercise testing,8 the timing of CPX in the current case may have been too early. It is noteworthy that 3 to 5 days after admission has been reported as the late peak when left ventricular rupture frequently occurs because the damaged myocardium is still fragile 9. Second, our case suggests that certain patients should be exempted from CPX before discharge.…”

Section: Discussionmentioning

confidence: 70%

Left ventricular free-wall rupture that occurred during a cardiopulmonary exercise test

Kodaira¹,

Itoh

Koizumi

et al. 2018

BMJ Case Reports

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Although exercise testing has become a standard procedure before discharge for patients with acute coronary syndrome, a fatal accident during the test is extremely rare. A 60-year-old man was admitted for a non-ST-segment elevation myocardial infarction. A coronary angiogram showed stenosis at the distal lesion of the circumflex, and a balloon angioplasty was performed. His recovery was smooth, and a cardiopulmonary exercise test was performed 5 days after admission. At 2.5 metabolic equivalents, he suddenly went into cardiac arrest, and percutaneous cardiopulmonary support was initiated. Echocardiography revealed the presence of a large amount of pericardial effusion, and emergency cardiac surgery was performed to repair the free-wall rupture. This highlights the importance of careful monitoring of patients with percutaneous coronary intervention during cardiopulmonary exercise testing.

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“…However, anterior/lateral infarction, female sex and age over 70 years remain important risk factors for cardiac rupture 4. In the modern treatment era, the incidence of free wall cardiac rupture in a recently published series was 1.3% with almost 50% of the patients experiencing rupture within 24 hours and with an extremely high mortality of almost 90% 5. Successful restoration of the coronary artery patency after occlusion, either due to mechanical desobliteration or, as it is shown in our case, with spontaneous reperfusion, does not always lead to adequate reperfusion at the microvascular level.…”

Section: Discussionmentioning

confidence: 99%

Necrotising coronaritis with fatal outcome

Schweizer

Fischer

Fehr³

et al. 2017

BMJ Case Reports

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A 56-year-old woman presented with acute onset of typical chest pain. She was diagnosed with acute coronary syndrome with ST-segment elevation myocardial infarction. Although significant obstructive coronary artery disease was ruled out by coronary angiography, cardiac MRI showed transmural necrosis of the lateral free wall with extensive microvascular obstruction consistent with ischaemic heart disease. Within 48 hours after initial presentation, the patient suddenly arrested due to pulseless electrical activity with futile resuscitation efforts. Autopsy revealed myocardial perforation with extensive haematothorax due to pericardial laceration, caused by the mechanical chest compressions. Eventually, histology identified diffuse necrotising coronary vasculitis as a rare cause of ischaemic heart disease.

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Clinical manifestation of early phase left ventricular rupture complicating acute myocardial infarction in the primary PCI era

Abstract: Even in the patients' cohort with higher prevalence of primary PCI, LV rupture cases were not decreased in contrast to our expectations. More attention should be paid to early LV rupture cases within 24 h from symptom onset in those cases.

Cited by 32 publications

References 24 publications

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Risk Factors for Cardiac Rupture Complicating Myocardial Infarction: A PRISMA Meta-Analysis and Systematic Review

Left ventricular free-wall rupture that occurred during a cardiopulmonary exercise test

Necrotising coronaritis with fatal outcome

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