Rupture of the heart as a complication of a heart attack

heart failure occur most often in patients with myocardial infarction and are a serious and often fatal complication of this disease.

heart rupture - a violation of the integrity of the heart muscle.cardiac rupture can occur during heart trauma, inflammatory, infiltrative tumor and heart disease, but it is becoming the most common cause of myocardial infarction.

heart break to occur in 3-10% of patients with myocardial infarction and are the third leading cause of death in these patients.It is about breaking hearts, as a complication of myocardial infarction, and will be discussed.

Classification

There are external and internal ruptures.When external rupture defect is formed in the wall of the ventricle, and blood poured into the cavity of the pericardium (slit-like space that surrounds the heart and shuts him from the other organs of the chest).

The internal fractures include fractures of the interventricular septum and the papillary muscles, which are attached to the heart valves.Exterior gaps

constitute 85-90% of all heart failure.

also shared the early and late breaks.Early breaks occur in the first days of the disease, on the border between the unaffected (cutting) and dead (nektrotizirovannoy) of the heart tissue.At a later date breaks are less frequent and develop as a result of the growing tension and thinning the necrotic areas of the heart muscle.

also gaps can be slow-and cross-sectional, complete and incomplete.

Risk Factors

Risk factors for heart failure include myocardial infarction:

  • female gender (women gaps observed in 2 times more often than men);
  • elderly age;
  • first myocardial infarction;
  • extensive and transmural (through the wall of the heart muscle), myocardial damage;
  • late hospitalization (within 24 hours from the onset of the disease);
  • high blood pressure;
  • excessive physical activity in the first week after myocardial infarction.

clinical picture

clinical picture external divide the sum of the signs and symptoms prescission period of cardiac tamponade.

For prescission period characterized by complaints of extremely intense pain in the heart, is often given in the interscapular region.It noted a progressive decrease in blood pressure, cold clammy sweat, thready pulse.Pain and symptoms of shock defy conventional treatment.

myocardial rupture can develop as a sudden (80-90% of cases), and slow.At the time of the sudden rupture of blood from the left ventricle cavity quickly poured into the cavity of the pericardium.Next gemotamponada develops, leading to cardiac arrest.The patients lose consciousness, there is a sharp cyanosis (cyanosis) of the face and upper body, swelling of the neck veins, disappearing pulse and blood pressure.After 1-2 minutes comes respiratory arrest.The only treatment is emergency cardiac surgery, but its performance is almost always unrealistic because of the speed of development of severe complications of myocardial infarction.

Slowly the current ventricular wall rupture may take several hours or even days.The clinical picture of him as follows: intensive, not amenable to drug therapy, pain in the heart (ie, increasing, the sagging), signs of shock.Urgent ultrasound confirms the presence of the liquid (blood) between the sheets of pericardium.Unfortunately, most patients with slow current of myocardial rupture and die.However, in some cases it is possible to carry out a puncture of the pericardial cavity (to remove blood streamed) and urgent surgical intervention to restore the integrity of the left ventricle.

When

ventricular septal rupture appear sudden sharp chest pain, there is a sharp decrease in blood pressure.Develops progressive right ventricular failure (due to the occurrence of the gap between the ventricles of the heart and blood discharge from the left ventricle to the right) with pain in the right hypochondrium due to a sharp increase in the liver.There is a swelling of the neck veins.Sometimes patients survive until the swelling in the feet and legs, and the development of ascites (fluid in the abdominal cavity).The prognosis for ventricular septal rupture depends on the size of the gap, the severity of the shock, and other complications of myocardial infarction and timely surgical intervention.

When you break papillary (papillary) left ventricular muscle fast growing congestion in the lungs.Appears shortness of breath, wheezing in the lungs, decreased blood pressure.Complete rupture of the left ventricle papillary muscles is incompatible with life due to the rapid development of pulmonary edema.Partial rupture of papillary muscles of patients can manage to operate.

important at the very beginning of myocardial infarction to be able to identify patients at high risk of heart attack, perform the appropriate treatment and rehabilitation measures and prevent the patient's death.

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