Browsing by keyword "Heart Rupture"

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    • Factors related to heart rupture in acute coronary syndromes in the Global Registry of Acute Coronary Events
      Lopez-Sendon, Jose; Gurfinkel, Enrique P.; Lopez de Sa, Esteban; Agnelli, Giancarlo; Gore, Joel M.; Steg, Phillippe Gabriel; Eagle, Kim A.; Cantadore, Jose Ruiz; FitzGerald, Gordon; Granger, Christopher B. (2010-06-17)
      AIMS: To determine the incidence and factors associated with heart rupture (HR) in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: Among 60 198 patients, 273 (0.45%) had HR (free wall rupture, n = 118; ventricular septal rupture, n = 155). Incidence was 0.9% for ST-segment elevation myocardial infarction (STEMI), 0.17% for non-STEMI, and 0.25% for unstable angina. Hospital mortality was 58 vs. 4.5% in patients without HR (P < 0.001). The incidence was lower in STEMI patients with primary percutaneous coronary intervention (PCI) than in those without (0.7 vs. 1.1%; P = 0.01), but primary PCI was not independently related to HR in adjusted analysis (P = 0.20). Independent variables associated with HR included: ST-segment elevation (STE)/left bundle branch block; ST-segment deviation; female sex; previous stroke; positive initial cardiac biomarkers; older age; higher heart rate; systolic blood pressure/30 mmHg decrease. Conversely, previous MI and the use of low-molecular-weight heparin and beta-blockers during first 24 h were identified as protective factors for HR. CONCLUSION: The incidence of HR is low in patients with ACS, although its incidence is probably underestimated. Heart rupture occurs more frequently in ACS with STE and is associated with high hospital mortality. A number of variables are independently related to HR.

    • Rupture of the interventricular septum complicating acute myocardial infarction: a multicenter analysis of clinical findings and outcome
      Held, A. C.; Cole, P. L.; Lipton, B.; Gore, Joel M.; Antman, E. M.; Hockman, J. S.; Corrao, Jeanne M.; Goldberg, Robert J.; Alpert, Joseph S. (1988-11-01)
      Acute ventricular septal rupture in the setting of acute myocardial infarction continues to present clinicians with a difficult therapeutic dilemma. The role of surgical intervention and its timing remains unresolved. A collaborative study from three institutions was undertaken to examine various clinical outcomes in 46 patients with ventricular septal rupture. No medically treated patient survived hospitalization. Since only surgically treated patients survived, we focused our evaluation on those characteristics that might differentiate surgical survivors from surgical nonsurvivors. Systolic blood pressure, pulse, mean right atrial pressure, left ventricular systolic pressure, and cardiopulmonary bypass time were univariate predictors of hospital survival. Multivariate analysis revealed that systolic blood pressure, right atrial pressure, and cardiopulmonary bypass time were strongly predictive of survival (p less than 0.05). In addition, taken together systolic blood pressure and right atrial pressure identified a group of persons who wee much more likely to survive surgical intervention. The results of this study may prove useful in predicting the risk of surgical repair in patients with ventricular septal rupture.