Cardiac rupture complicating acute myocardial infarction in presence of normal electrocardiogram

Subacute left ventricular free wall rupture. Surgical repair prompted by echocardiographic diagnosis

Subacute cardiac rupture may occur in patients with electrocardiographic and enzyme evidence of transmural myocardial infarction. In the unusual case we encountered, these changes were absent. The echocardiographic observation of an echo-dense area within the pericardial space, due to an organized thrombus, provided early diagnosis of cardiac rupture and prompted surgery.

Cardiac rupture--challenge in diagnosis and management

Previous studies of the incidence, natural history, pathogenesis and diagnosis of cardiac rupture are presented, and 20 additional cases described. Progressive cardiorrhexis after myocardial infarction causes death in possibly more than 25,000 persons a year in the United States, and more frequent antemortem diagnosis is needed. Suggestions for future clinical and experimental studies are described and possible means of early diagnosis and therapy are outlined.