Expansion of Transmural Myocardial Infarction A Pathophysiologic Factor in Cardiac Rupture

  title={Expansion of Transmural Myocardial Infarction A Pathophysiologic Factor in Cardiac Rupture},
  author={Edgar Howard Schuster and Bernadine H. Bulkley},
SUMMARYThe 10–20% incidence of cardiac rupture in acute fatal myocardial infarction has not changed in the past century, and little is known about its pathophysiology. To determine whether expansion acute dilatation and thinning of the area of infarction not explained by resorption of necrotic tissue – may be a variable predictive for rupture, we studied 110 consecutive autopsied patients who died of acute myocardial infarction. The presence and severity of expansion was determined… 

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Eight fatalities due to cardiac rupture, of 40 consecutively autopsied myocardial infarctions, were clinicopathologically examined and postinfarction cardiac rupture occurring in relatively later phase was considered to be mainly due to weakness of infarcted wall, with less influence factors of mechanical stress such as physical exertion, hypertension, or intracardiac pressure.
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The data suggest that in the acute phase, but not the subacute phase, the degree of expansion and the proportion of expansion to infarcted area are associated with rupture.
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