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Ruptured acute myocardial infarction (MI). A. Hemopericardium in a 70-year-old man with history of chest pain and diagnosis of acute transmural infarction
who died suddenly while walking to the bathroom 24 hours after admission. B1. The pericardium contained 300 mL of blood, and a rupture site was
identified on the posterior wall of the left ventricle. Note the early transmural infarct (pale area on the posterior wall [arrows]) with the rupture site close to
the viable myocardium but within the infarct zone. B2. A lateral wall rupture. Note that the rupture site is close to the viable and infarcted myocardium
(arrowheads). C. A 50-year-old man presented with chest pain of 7 hours' duration. He received streptokinase and underwent balloon angioplasty of the
proximal left anterior descending coronary artery. At autopsy, the patient had hemopericardium and a transmural hemorrhagic reperfused infarct that
Source: Chapter 57. Pathology of Myocardial Ischemia, Infarction, Reperfusion, and Sudden Death, Hurst's The Heart, 13e
involved the anteroseptal wall of left ventricle. The rupture occurred close to the viable myocardium on the anterior wall. D. Rupture of the posterior
Citation:
Fuster2 V,
Walsh
RA,anHarrington
13e; 2011
Available
at: http://mhmedical.com/
Accessed:
May 10,
2017rupture
ventricular septum
(arrow)
weeks
after
acute MI. RA.
TheHurst's
patient The
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with severe
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was clinically missed. (A four-chamber cut had been made before short-axis slicing.) E. Ventricular septal rupture involving the inferobasal portion of the
heart, which extends through the posterior septum and into the right ventricular, causing a dissection of the posterior wall of the right ventricle. F. A highpower view of the inferobasal portion of the heart showing the rupture through the septum extending into the right ventricle and piercing the right ventricular