Vlodaver Z, Edwards J E
Circulation. 1977 May;55(5):815-22. doi: 10.1161/01.cir.55.5.815.
Ninety-eight specimens with rupture of some portion of the left ventricle complicating acute myocardial infarction from atherosclerotic coronary disease were studied. In 90, a single structure (so-called isolated rupture) had ruptured as follows: free wall of left ventricle, 52 cases; ventricular septum, 18 cases; a papillary muscle, 20 cases. In eight cases, two structures had ruptured, the most common combination being rupture of ventricular septum and left ventricular wal. Inferolateral location of underlying infarction was the common situation in ruptured papillary muscle, while anteroseptal myocardial infarction was more common in rupture of the ventricular septum. Transmural infarction underlay each case of ruptured ventricular septum, while in ruptured papillary muscle 11 of 20 cases showed subendocardial infarction. There was no association between the type of papillary muscle rupture and the type of infarct. Clinically, collapse of the circulation was common in cases of ruptured ventricular septum and ruptured papillary muscle. Death within one week after rupture was usual when the papillary muscle was involved totally or when the ventricular septum was involved. With partial rupture of a papillary muscle, longer survival (months) was observed in two of ten cases.
对98例因动脉粥样硬化性冠心病并发急性心肌梗死导致左心室部分破裂的标本进行了研究。其中90例为单一结构破裂（所谓的孤立性破裂），具体情况如下：左心室游离壁破裂52例；室间隔破裂18例；乳头肌破裂20例。8例为两个结构破裂，最常见的组合是室间隔和左心室壁破裂。乳头肌破裂时，梗死灶多位于下外侧，而室间隔破裂时，前间隔心肌梗死更为常见。每例室间隔破裂均有透壁性梗死，而20例乳头肌破裂中有11例表现为心内膜下梗死。乳头肌破裂类型与梗死类型之间无关联。临床上，室间隔破裂和乳头肌破裂患者常出现循环衰竭。乳头肌完全受累或室间隔受累时，破裂后一周内通常死亡。乳头肌部分破裂的10例患者中有2例存活时间较长（数月）。
