Rupture of the Heart

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Abstract
In 1,001 consecutive autopsies of acute myocardial infarction the incidence of rupture of the heart was 4.7%. The group with rupture compared to a control group of 200 consecutive cases of acute fatal myocardial infarction without rupture indicated the lack of influence of hypertension, exertion, shock, congestive failure and anticoagulant therapy. The age of 69 was the same in both groups but women with myocardial infarction had a 6.9% chance of developing cardiac rupture whereas men had a 3.8% chance. Approximately 1/2 of the patients in both groups died within the first 3 days. Repeated or protracted chest pain was a fecture of impending rupture in 55%. The most outstanding pathologic observation was the high incidence of cornonary thrombosis in 70% of the rupture cases as compared to 29% of the cases without rupture. An additional 6% of the rupture cases showed acute occlusion due to intimal hemorrhage or athero-matous debris indicating that intense necrosis without adequate collateral circulation may lead to cardiac rupture.