Myocardial rupture in acute myocardial infarction: case report and review of the literature.

Our patient demonstrates why the diagnosis of myocardial rupture is often mistaken for an extension of a myocardial infarction. Our case further suggests, as supported in the literature, that myocardial rupture is not an abrupt event. With close monitoring in patients with high risks, it is possible, especially with use of echocardiograms, to make an early diagnosis. Once the diagnosis is made, aggressive surgical therapy should be undertaken. With the advances in cardiovascular surgery, the prognosis of cardiac rupture is vastly improved. Long-term prognosis for patients surviving surgical repair after myocardial rupture is excellent. However, one should keep in mind the importance of preventive therapy such as treatment of systolic hypertension on admission to the coronary care unit.