Circulation, Vol 55, 815-822, Copyright © 1977 by American Heart Association
Z Vlodaver and JE Edwards
Ninety-eight specimens with rupture of some portion of the left ventricle
complicating acute myocardial infarction from atherosclerotic coronary
disease were studied. In 90, a single structure (so-called isolated
rupture) had ruptured as follows: free wall of left ventricle, 52 cases;
ventricular septum, 18 cases; a papillary muscle, 20 cases. In eight cases,
two structures had ruptured, the most common combination being rupture of
ventricular septum and left ventricular wal. Inferolateral location of
underlying infarction was the common situation in ruptured papillary
muscle, while anteroseptal myocardial infarction was more common in rupture
of the ventricular septum. Transmural infarction underlay each case of
ruptured ventricular septum, while in ruptured papillary muscle 11 of 20
cases showed subendocardial infarction. There was no association between
the type of papillary muscle rupture and the type of infarct. Clinically,
collapse of the circulation was common in cases of ruptured ventricular
septum and ruptured papillary muscle. Death within one week after rupture
was usual when the papillary muscle was involved totally or when the
ventricular septum was involved. With partial rupture of a papillary
muscle, longer survival (months) was observed in two of ten cases.
ARTICLES
Rupture of ventricular septum or papillary muscle complicating myocardial infarction
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