2.Left ventricular free wall rupture during late mechanical reperfusion for acute myocardial infarction.
Hong-Bo YANG ; Dong HUANG ; Feng ZHANG ; Lei GE ; Ju-Ying QIAN ; Jun-Bo GE
Chinese Medical Journal 2013;126(22):4300-4300
Aged
;
Fatal Outcome
;
Heart Rupture
;
etiology
;
Humans
;
Male
;
Myocardial Infarction
;
therapy
3.One case report of sudden death due to ruptured aortic sinus aneurysm into right ventricle.
Hui-fang MA ; Guo-hua XUE ; Shou-yan ZHANG
Chinese Journal of Cardiology 2011;39(11):1048-1049
Adult
;
Aortic Rupture
;
pathology
;
Death, Sudden, Cardiac
;
etiology
;
Heart Ventricles
;
pathology
;
Humans
;
Male
4.Rupture of Right Ventricular Free Wall Following Ventricular Septal Rupture in Takotsubo Cardiomyopathy with Right Ventricular Involvement.
June Min SUNG ; Sung Jin HONG ; In Hyun CHUNG ; Hye Young LEE ; Jae Hoon LEE ; Hyun Jung KIM ; Young Sup BYUN ; Byung Ok KIM ; Kun Joo RHEE
Yonsei Medical Journal 2017;58(1):248-251
Most patients diagnosed with takotsubo cardiomyopathies are expected to almost completely recover, and their prognosis is excellent. However, complications can occur in the acute phase. We present a case of a woman with takotsubo cardiomyopathy with right ventricular involvement who developed a rupture of the right ventricular free wall following ventricular septal rupture, as a consequence of an acute increase in right ventricular afterload by left-to-right shunt. Our case report illustrates that takotsubo cardiomyopathy can be life threatening in the acute phase. Ventricular septal rupture in biventricular takotsubo cardiomyopathy may be a harbinger of cardiac tamponade by right ventricular rupture.
Acute Disease
;
Aged
;
Female
;
Heart Ventricles/injuries
;
Humans
;
Prognosis
;
Takotsubo Cardiomyopathy/*complications
;
Ventricular Septal Rupture/*etiology
5.Article: A case of a twisted heart due to blunt trauma (SMJ Vol 43 Issue 8 August 2002).
Singapore medical journal 2002;43(11):590-590
Accidents, Traffic
;
Adult
;
Heart Injuries
;
complications
;
etiology
;
pathology
;
Hernia
;
etiology
;
pathology
;
Humans
;
Male
;
Pericardium
;
injuries
;
Rupture
;
Wounds, Nonpenetrating
;
complications
6.Morphological analysis of cardiac rupture due to blunt injury, cardiopulmonary resuscitation and myocardial infarction in forensic pathology.
Dianshen WANG ; Fu ZHANG ; Yunle MENG ; Yangeng YU ; Kai ZHOU ; Leping SUN ; Qi MIAO ; Dongri LI
Journal of Southern Medical University 2018;38(12):1514-1520
OBJECTIVE:
To analyze the morphological features and forensic pathological characteristics of cardiac ruptures of different causes for their differential diagnosis.
METHODS:
We analyzed the data of 44 autopsy cases of cardiac rupture from 2014 to 2017 in our institute, including 11 cases caused by blunt violence with intact pericardium, 4 caused by cardiopulmonary resuscitation (CPR), 9 by myocardial infarction, and 20 by aorta dissection rupture.The gross features and histopathological characteristics of cardiac rupture and pericardial effusion were analyzed and compared.
RESULTS:
Cardiac ruptures caused by blunt violence varied in both morphology and locations, and multiple ruptures could be found, often accompanied with rib or sternum fractures; the volume of pericardial effusion was variable in a wide range; microscopically, hemorrhage and contraction band necrosis could be observed in the cardiac tissue surrounding the rupture.Cardiac ruptures caused by CPR occurred typically near the apex of the right ventricular anterior wall, and the laceration was often parallel to the interventricular septum with frequent rib and sternum fractures; the volume of pericardial blood was small without blood clots; microscopic examination only revealed a few hemorrhages around the ruptured cardiac muscular fibers.Cardiac ruptures due to myocardial infarction caused massive pericardial blood with blood clots, and the blood volume was significantly greater than that found in cases of CPR-induced cardiac rupture ( < 0.05);lacerations were confined in the left ventricular anterior wall, and the microscopic findings included myocardial necrosis, inflammatory cell infiltration, and mural thrombus.Cardiac tamponade resulting from aorta dissection rupture was featured by massive pericardial blood with blood clots, and the blood volume was much greater than that in cases of cardiac ruptures caused by blunt violence, myocardial infarction and CPR ( < 0.05).
CONCLUSIONS
Hemorrhage, inflammatory cell infiltration, and lateral thrombi around the cardiac rupture, along with pericardial blood clots, are all evidences of antemortem injuries.
Aneurysm, Dissecting
;
complications
;
Aortic Aneurysm
;
complications
;
Cardiopulmonary Resuscitation
;
adverse effects
;
Forensic Pathology
;
Heart Rupture
;
etiology
;
pathology
;
Heart Rupture, Post-Infarction
;
pathology
;
Humans
;
Myocardial Contusions
;
complications
7.The early and middle-long term clinical results of surgical treatment for ventricular septal rupture.
Hui-Li GAN ; Jian-Qun ZHANG ; Bao-Tian CHEN ; Qi-Wen ZHOU ; Cheng-Xiong GU ; Fang-Jiong HUANG ; Sheng-Xun WANG ; Si-Hong ZHENG ; Jun-Sheng MU
Chinese Journal of Surgery 2009;47(6):457-460
OBJECTIVETo explore the way of promoting the efficacy of surgical treatment for ventricular septal rupture (VSR) after acute myocardium infarction in terms of perioperative and long term survival.
METHODSThe clinic data of 37 VSR cases underwent surgical treatment from October 1994 to October 2007 were analyzed retrospectively. There were 24 male and 13 female, and the age was (63.4 +/- 7.6) years old. The whole group was divided into the VSR repair plus revascularization group (group A, 26 cases) and simple VSR repair group (group B, 11 cases).
RESULTSThere were 4 operative deaths in group A (15.4%), 7 deaths in group B (63.6%), P = 0.006. With the follow-up of (34.0 +/- 29.8) months ranged from 2 to 103 months of the 26 operational survivors, there were 5 late deaths, of which 2 deaths in group A and 3 deaths in group B. According to the Kaplan-Meier survival curve, the actuarial survival rate at 6 to 8 year was (64.3 +/- 21.0)% for group A and the actuarial survival rate at 4 year was (25.0 +/- 21.7)% for group B, P = 0.011. Of the 21 mid-long term survivors, 17 cases were in NYHA class I to II and 4 cases in NYHA class III to IV. There were 4 cases suffered from VSR recurrence. According to Logistic regression, the risk factors for the early death were not adoptive of revascularization, cardiogenic shock and emergency surgical procedure, while the risk factors for late death were not adoptive of revascularization and low cardiac output after the procedures.
CONCLUSIONSVSR repair plus revascularization could improve the perioperative and mid-long term survival for the surgical treatment of VSR. The appropriate timing and procedures of the surgical operation are very important to promote perioperative survival and to prevent VSR recurrence.
Aged ; Female ; Follow-Up Studies ; Heart Rupture, Post-Infarction ; surgery ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; Retrospective Studies ; Treatment Outcome ; Ventricular Septal Rupture ; etiology ; surgery
10.Delayed Ventricular Septal Rupture after Percutaneous Coronary Intervention in Acute Myocardial Infarction.
Ji Young PARK ; Seong Hoon PARK ; Ji Young OH ; In Je KIM ; Yu Hyun LEE ; Si Hoon PARK ; Ki Hwan KWON
The Korean Journal of Internal Medicine 2005;20(3):243-246
In the era before reperfusion therapy, ventricular septal rupture complicated 1~3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the mid-portion of the left anterior descending artery (LAD), and the lesion was successfully treated by percutaneous coronary intervention (PCI) with stent implantation. After PCI, the anterior wall motion improved on the follow-up echocardiogram. However, on the 20th hospital day, the patient condition deteriorated suddenly with pulmonary congestion. The echocardiography revealed a 1.3 cm ventricular septal defect at the apical septum with a left-to-right shunt. We report this rare case of delayed septal rupture in a patient with patent LAD after PCI and recovery of wall motion.
Ventricular Septal Rupture/*etiology
;
Time Factors
;
Stents
;
Myocardial Infarction/*complications/surgery
;
Humans
;
Heart Ventricles/*physiopathology
;
Heart Septum/*physiopathology
;
Female
;
Angioplasty, Transluminal, Percutaneous Coronary
;
Aged
;
Acute Disease