Shapira I, Isakov A, Burke M, Almog C
Chest. 1987 Aug;92(2):219-23. doi: 10.1378/chest.92.2.219.
The occurrence of myocardial rupture was evaluated in an unselected population of 1,737 patients with acute myocardial infarction (AMI). Patients with cardiac rupture after AMI were compared with age- and sex-matched control patients with fatal AMI not related to rupture and with AMI survivors discharged home. Rupture was found in 40 patients (15.7 percent of hospital deaths), or 2.3 percent of all cases of AMI. At the highest risk for rupture were women aged 60 to 69, although the age distribution did not differ significantly from that of patients dying of other causes. More patients with myocardial rupture had hypertension during hospitalization, persistent pain, and inferior wall myocardial infarction when compared with controls. The majority (95 percent) of cardiac ruptures occurred within the first six days, 40 percent within the first 24 hours after the onset of symptoms. Approximately 20 percent of ruptures were diagnosed as subacute; in only two was surgical intervention attempted unsuccessfully. The high-risk group of patients should be carefully monitored within the first six days after the onset of symptoms of AMI in an effort to prevent myocardial rupture.
在1737例急性心肌梗死（AMI）患者的非选择性人群中评估心肌破裂的发生情况。将AMI后发生心脏破裂的患者与年龄和性别匹配的非破裂性致命AMI对照患者以及出院回家的AMI幸存者进行比较。在40例患者中发现了破裂（占医院死亡人数的15.7%），占所有AMI病例的2.3%。60至69岁的女性发生破裂的风险最高，尽管其年龄分布与死于其他原因的患者没有显著差异。与对照组相比，更多心肌破裂患者在住院期间患有高血压、持续性疼痛且为下壁心肌梗死。大多数（95%）心脏破裂发生在头6天内，40%发生在症状出现后的头24小时内。约20%的破裂被诊断为亚急性；仅2例尝试手术干预但未成功。应在AMI症状出现后的头6天内对高危患者进行仔细监测，以预防心肌破裂。
