Postinfarction cardiac rupture: surgical success and review of the literature.

Cardiac rupture following myocardial infarction has been reported as the cause of 4 to 24% of all infarction deaths. The rupture may occur from a few hours to several days after the myocardial infarction and is not a true "blowout" but rather a necrotic hemorrhagic area in the center of the infarction that extravasates blood and leads to pericardial tamponade. The most common findings when rupture occurs are renewed chest pain, bradycardia, and shock. Two patients with postinfarction myocardial rupture who were operated on successfully are reported. With prompt diagnosis and treatment, more of these patients would survive long enough to undergo operation. With cardiopulmonary bypass the repair of these ruptures is not difficult.