Myocardial Rupture Differential Diagnoses
- Author: Jamshid Shirani, MD; Chief Editor: Eric H Yang, MD more...
Physicians should have a high index of suspicion for myocardial rupture after acute myocardial infarction (AMI). Especially during the first week, it is critical to make the diagnosis and perform emergency life-saving interventions as expeditiously as possible. Failure to diagnose or act quickly could expose physicians to legal liability.
The possibility of cardiac injury should be considered in all patients with high-velocity deceleration blunt injuries. Failure to diagnose myocardial rupture or early discharge of stable patients from the emergency department could result in serious legal consequences.
In addition to the conditions listed in the differential diagnosis, other problems to be considered include true ventricular aneurysm and cardiac contusion.
Helmy TA, Nicholson WJ, Lick S, Uretsky BF. Contained myocardial rupture: a variant linking complete and incomplete rupture. Heart. 2005 Feb. 91(2):e13. [Medline].
Okino S, Nishiyama K, Ando K, Nobuyoshi M. Thrombolysis increases the risk of free wall rupture in patients with acute myocardial infarction undergoing percutaneous coronary intervention. J Interv Cardiol. 2005 Jun. 18(3):167-72. [Medline].
Kumar S, Kaushik S, Nautiyal A, et al. Cardiac rupture in takotsubo cardiomyopathy: a systematic review. Clin Cardiol. 2011 Nov. 34(11):672-6. [Medline].
Dumont E, Rodés-Cabau J, De LaRochellière R, Lemieux J, Villeneuve J, Doyle D. Rapid pacing technique for preventing ventricular tears during transapical aortic valve replacement. J Card Surg. 2009 May-Jun. 24(3):295-8. [Medline].
Javaid MM, Grigoriou A, Katsianos D, Kon SP. Nephrotic and anti-phospholipid syndromes: Multisystem conditions associated with acute myocardial infarction in young patients. J Ren Care. 2011 Sep 14. [Medline].
Honda S, Asaumi Y, Yamane T, et al. Trends in the clinical and pathological characteristics of cardiac rupture in patients with acute myocardial infarction over 35 years. J Am Heart Assoc. 2014 Oct 20. 3(5):e000984. [Medline].
Suzuki M, Enomoto D, Seike F, Fujita S, Honda K. Clinical Features of Early Myocardial Rupture of Acute Myocardial Infarction. Angiology. 2011 Nov 8. [Medline].
Hayashi T, Hirano Y, Takai H, et al. Usefulness of ST-segment elevation in the inferior leads in predicting ventricular septal rupture in patients with anterior wall acute myocardial infarction. Am J Cardiol. 2005 Oct 15. 96(8):1037-41. [Medline].
Mehta RH, Grab JD, O'Brien SM, et al. Clinical characteristics and in-hospital outcomes of patients with cardiogenic shock undergoing coronary artery bypass surgery: insights from the Society of Thoracic Surgeons National Cardiac Database. Circulation. 2008 Feb 19. 117(7):876-85. [Medline].