Mechanical complications of acute myocardial infarction

Cardiol Clin. 2013 Nov;31(4):519-31, vii-viii. doi: 10.1016/j.ccl.2013.07.004. Epub 2013 Aug 13.

Abstract

Acute myocardial infarction (AMI) can result in ischemic, mechanical, arrhythmic, embolic, or inflammatory complications. The development of mechanical complications following AMI is associated with a significantly reduced short-term and long-term survival. Since the introduction of primary percutaneous coronary intervention as the principal reperfusion strategy following acute ST-elevation myocardial infarction, the incidence of mechanical complications, including rupture of the left ventricular free wall, papillary muscle, and ventricular septum, has reduced significantly to less than 1%. Despite high operative mortality, the lack of an effective medical alternative makes surgical repair the mainstay of current management for these patients.

Keywords: Acute myocardial infarction; Infarct exclusion technique; Left ventricular free wall rupture; Papillary muscle rupture; Ventricular septal rupture.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods
  • Cardiac Imaging Techniques
  • Cardiotonic Agents / therapeutic use
  • Heart Rupture, Post-Infarction / diagnosis
  • Heart Rupture, Post-Infarction / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / etiology
  • Mitral Valve Insufficiency / therapy
  • Myocardial Revascularization / methods
  • Postoperative Care / methods
  • Preoperative Care / methods
  • Treatment Outcome
  • Watchful Waiting

Substances

  • Cardiotonic Agents