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2017, Number 1

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CorSalud 2017; 9 (1)

Cardiac rupture as a complication of acute myocardial infarction

Pérez SD, Alonso HA, Ramos GHL, Pérez SD, Ferrer PA

Language: Spanish
References: 29
Page: 1-9
PDF size: 394.17 Kb.


ABSTRACT

Introduction: The main causes of death in patients with myocardial infarction are cardiac arrhythmias and mechanical complications. Within them, cardiac rupture causes a severe hemodynamic compromise with a high mortality rate. Objective: To characterize patients who died of cardiac rupture as a complication of acute myocardial infarction. Method: A descriptive, cross-sectional study at the Arnaldo Milián Castro Uni-versity Hospital in Santa Clara, Cuba, between 2010 and 2014. All patients who died with a clinical diagnosis of acute myocardial infarction, who underwent autopsy and were confirmed a cardiac rupture, were studied. Results: There were prevalence of female sex (53.2%), advanced age (more than 75 years), smoking (64.5%), hypertension (61.3%), and absence of angina (96.8%). 43 patients (69.4%) did not undergo thrombolysis, 31 of them (72.1%) had an atypi-cal infarction presentation. Left ventricular free wall rupture (91.9%) was the most frequent. Cardiac tamponade was identified in 80.7% of the patients and cardio-genic shock in 17.7%. Almost half of those who had free wall rupture (47.3%) had an extensive extensive anterior wall myocardial infarction. Conclusions: Female patients over 75 years old, with smoking, hypertension and diabetes mellitus predominated. Most of the patients did not have previous angina, did not receive thrombolytic treatment, and showed atypical clinical presentation. Free wall rupture was the most frequent, and almost half of those who suffered it had an extensive anterior wall myocardial infarction.


REFERENCES

  1. Silva Paradela S, Torres Senra L, Rodríguez Rodrí-guez AI. Isquemia silente en cuidados intensivos: una amenaza potencial. Rev Cubana Med Inten-siv Emerg [Internet]. 2006 [citado 14 Mar 2016];5: 469-86. Disponible en: http://bvs.sld.cu/revistas/mie/vol5_3_06/mie07306.pdf

  2. Castillo Arocha I, Armas Rojas NB, Dueñas Herre-ra A, González Greck OR, Arocha Mariño C, Casti-llo Guzmán A. Riesgo cardiovascular según tablas de la OMS, el estudio Framingham y la razón apolipoproteína B/apolipoproteína A1. Rev Cuba-na Invest Bioméd [Internet]. 2010 [citado 14 Mar 2016];29:479-88. Disponible en: http://scielo.sld.cu/pdf/ibi/v29n4/ibi08410.pdf

  3. Leone A. Hypertension and sudden cardiac death: their relationship in postinfarction cardiac rupture. J Am Soc Hypertens. 2015;9(Supl. 4S):e59 [Resumen].

  4. Delcán Domínguez J. Cardiopatía Isquémica. Madrid: Cardigam Multimedia; 1999. p. 557-91.

  5. Antman EM, Morrow DA. Infarto de miocardio con elevación del segmento ST: tratamiento. En: Bonow RO, Mann DL, Zipes DP, Libby P, Braun-wald E, editores. Braunwald Tratado de Cardiolo-gía: Texto de Medicina Cardiovascular. 9na. Ed. Barcelona: Elsevier; 2013. p. 1123-91.

  6. Yamada H, Sakurai A, Higurashi A, Takeda K. Cardiac CT for intraseptal pseudoaneurysm: im-pending double rupture of ventricular septum and left ventricular free wall. BMJ Case Rep [Internet]. 2015 [citado 14 Mar 2016];2015: bcr2014207352. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322251/pdf/bcr-2014-207352.pdf

  7. Murgueitio R, Merlano S, Rodríguez EJ. Conside-raciones sobre el valor pronóstico de los estudios de perfusión miocárdica. Rev Colomb Cardiol. 2014;21:95-7.

  8. Bonet Gorbea M, Varona Pérez P, Chang La Rosa M, García Roche RG, Suárez Medina R, Arcia Montes de Oca N, et al. III Encuesta de factores de riesgo y actividades preventivas de enferme-dades no transmisibles. Cuba 2010-2011. La Haba-na: Editorial Ciencias Médicas; 2014.

  9. Vargas-Barrón J, Roldán FJ, Romero-Cárdenas Á, Vázquez-Antona CA. Intramyocardial dissecting hematoma and postinfarction cardiac rupture. Echocardiography. 2013;30:106-13.

  10. 10.Unsöld B, Kaul A, Sbroggiò M, Schubert C, Regitz-Zagrosek V, Brancaccio M, et al. Melusin protects from cardiac rupture and improves functional re-modelling after myocardial infarction. Cardiovasc Res. 2014;101:97-107.

  11. 11.Díaz Águila H, Santos Monzón Y, Fragoso Estévez A, Rivero Nóbrega Y, Alonso Freire JL. Rotura del septo interventricular después de infarto agudo de miocardio con apertura y cierre intermitentes. CorSalud [Internet]. 2013 [citado 31 Mar 2016];5: 122-6. Disponible en:http://www.corsalud.sld.cu/sumario/2013/v5n1a13/civ.html

  12. 12.De Gennaro L, Brunetti ND, Ramunni G, Buquic-chio F, Corriero F, De Tommasi E, et al. Septal rupture with right ventricular Wall dissecting hae-matoma communicating with left ventricle after inferior myocardial infarction. Eur J Echocar-diogr. 2010:11:477-81.

  13. 13.Espinosa-Ledesma A, Ramírez-Orozco F, Herrera-Camacho G, Macías-Amezcua MD, González-Ojeda A, Fuentes-Orozco C. Mortalidad de la ruptura del septum interventricular posterior a infarto agudo del miocardio con manejo quirúrgi-co. Cir Ciruj. 2012;80:496-503.

  14. 14.Qian G, Liu Hb, Wang JW, Wu C, Chen YD. Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage. J Zhejiang Univ Sci B. 2013;14:736-42.

  15. 15.Ptaszyńska-Kopczyńska K, Sobolewska D, Ko-żuch M, Dobrzycki S, Sobkowicz B, Hirnle T, et al. Efficacy of invasive treatment and the occur-rence of cardiac rupture in acute ST-elevation myocardial infarction. Kardiol Pol. 2011;69:795-800.

  16. 16.Lahoz Tornos Á, Ray López VG, Arcas Meca R, Falcón Araña L. Rotura de pared libre de ven-trículo izquierdo tras infarto agudo de miocardio. A propósito de un caso. Rev Cubana Cardiol Cir Cardiovasc [Internet]. 2011 [citado 31 Mar 2016]; 17:102-05. Disponible en: http://www.bvs.sld.cu/revistas/car/vol17_1_11/car13111.pdf

  17. 17.Qian G, Wu C, Chen YD, Tu CC, Wang JW, Qian YA. Predictive factors of cardiac rupture in pa-tients with ST-elevation myocardial infarction. J Zhejiang Univ Sci B. 2014;15:1048-54.

  18. 18.Ministerio de Salud Pública. Anuario Estadístico de Salud 2013. La Habana: Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2014.

  19. 19.Baena Díez JM, del Val García JL, Alemany Vil-ches L, Martínez Martínez JL, Tomás Pelegrina J, González Tejón I, et al. Riesgo de presentación de eventos cardiovasculares según la agrupación de los factores de riesgo modificables en la pobla-ción mayor de 15 años de un centro de salud de Barcelona. Rev Esp Salud Pública. 2005;79:365-78.

  20. 20.Honda S, Asaumi Y, Yamane T, Kawakami S, Na-gai T, Noguchi T, et al. Long term trends in the clinical and pathological characteristics of cardiac rupture in patients with acute myocardial infarc-tion. J Card Fail. 2014;20:S156-7 [Resumen].

  21. Steg G, James SK, Atar D, Badano LP, Blomstrom Lundqvist C, Borger MA, et al. Guía de práctica clínica de la ESC para el manejo del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev Esp Cardiol. 2013;66:53.e1-e46.

  22. 22.Bueno H, Martínez-Sellés M, Pérez-David E, Ló-pez-Palop R. Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction. Eur Heart J. 2005;26:1705-11.

  23. Ikeda N, Yasu T, Kubo N, Hirahara T, Sugawara Y, Kobayashi N, et al. Effect of reperfusion therapy on cardiac rupture after myocardial infarction in Japanese. Circ J. 2004;68:422-6.

  24. 24.Markowicz-Pawlus E, Nozyński J, Sedkowska A, Jarski P, Hawranek M, Streb W, et al. Cardiac rup-ture risk estimation in patients with acute myo-cardial infarction treated with percutaneous coro-nary intervention. Cardiol J. 2007;14:538-43.

  25. 25.Massel DR. How sound is the evidence that thrombolysis increases the risk of cardiac rup-ture? Br Heart J. 1993;69:284-7.

  26. 26.Nakamura T, Masuda K, Hitomi E, Osaka Y, Na-kao T, Yoshimura N. Successful emergency de-partment thoracotomy for traumatic cardiac rup-ture: effective utilization of a fret sternum saw. Ulus Travma Acil Cerrahi Derg. 2014;20:217-20.

  27. 27.González Muñoz MF, Morera Domínguez O, Guevara de Arma E. Evaluación de los resultados de la trombólisis sistémica en el anciano. AMC [In-ternet]. 2008 [citado 31 Mar 2016];12:[aprox. 9 p.]. Disponible en: http://scielo.sld.cu/pdf/amc/v12n3/amc11308.pdf

  28. 28.Espinosa Brito AD, Alvarez Li FC, Borges Rodrí-guez E, Quintana Pérez S, Fernández Turner M. Estudio clínico-patológico de 460 fallecidos con infarto miocárdico agudo. Informe de dos series (1985-1987 y 1991-1993) Clín Cardiovasc (España). 2000;35:449-61.

  29. 29.Hernández Molina AC, Soria Pérez R, Merencio Leyva N, López Torres Y, Carmenate Pousada D. Correspondencia clínica y anátomo-patológica del infarto agudo de miocardio en el municipio de Mayarí. CCM [Internet]. 2014 [citado 31 Mar 2016];18:238-47. Disponible en: http://scielo.sld.cu/pdf/ccm/v18n2/ccm07214.pdf




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