Cardiac rupture during acute myocardial infarction : Autopsy study (2004-2020).

Autor: Oualha D; Department of Forensic Medicine, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., Ben Abderrahim S; Department of Forensic Medicine, Ibn El Jazzar University Hospital, Kairouan, Tunisia. Electronic address: sarra.ba98@hotmail.com., Ben Abdeljelil N; Department of Pathological Anatomy and Cytology, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., BelHadj M; Department of Forensic Medicine, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., Ben Jomâa S; Department of Forensic Medicine, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., Saadi S; Department of Forensic Medicine, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., Zakhama A; Department of Pathological Anatomy and Cytology, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia., Haj Salem N; Department of Forensic Medicine, Fattouma Bourguiba University Hospital, June 1st 1995 Street, 5000, Monastir, Tunisia.
Jazyk: angličtina
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2023 Jun; Vol. 72 (3), pp. 101601. Date of Electronic Publication: 2023 Apr 13.
DOI: 10.1016/j.ancard.2023.101601
Abstrakt: Introduction: Cardiac rupture is a rare but critical complication of myocardial infarction with an incidence of 1 to 3% of cases. We aimed in this autopsy study to analyze the anatomical, epidemiological, cardiac, and coronary profiles of cardiac rupture in the Monastir region.
Methods: We conducted a descriptive study with retrospective data collection of all cases of myocardial infarction complicated by a cardiac rupture over seventeen years (2004-2020).
Results: Thirty-one cases were included in this study. The mean age of the cases was 67 years with a male predominance. Sixteen cases (57%) had cardiovascular risk factors. The most common symptomatology reported before death was acute chest pain in 57% of cases. Fourteen cases (45%) corresponded to the definition of sudden cardiac death. At autopsy, the heart had a mean weight of 452.78 grams. A large hemopericardium was associated in 90% of cases. Myocardial rupture involved the posterior wall of the left ventricle in 50% of cases. The myocardial rupture occurred at a site of acute myocardial infarction in 86% of cases and on a myocardial scar in 14% of cases. The coronary study showed double or triple vessel atherosclerotic coronary artery disease in 57% of cases with fresh thrombi at the infarct-related coronary in 11% of cases.
Conclusions: Our analysis found that cardiac rupture mostly involved elderly subjects with underlying cardiovascular risk factors. Our findings sustain that age is a determining prognostic factor after acute coronary syndrome with the need for further education and awareness-raising efforts to speed up access to care for these patients.
Competing Interests: Conflict of interest The authors declare that they have no competing interests.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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