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Transcript
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 diedHeart, with severe congestive heart failure, and the diagnosis of ventricular septal Copyright © 2017 McGraw-Hill Education. All rights reserved 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