HEART RUPTURE IN ACUTE MYOCARDIAL-INFARCT ION - PREDICTION AND APPROACHES TO PREVENTION

Clinical, instrumental, and biochemical examinations were carried out in 587 patients with transmural myocardial infarctions (381 patients w ith the first infarction and 206 ones with the repeated disease). Hear t ruptures occurred in 5.7% of cases. Clinical forms and risk factors of heart rupture are described. Another group consisted of 815 patient s with the first transmural infarction; in 44 patients at a high risk of heart ruptures preventive therapy with pantripin and contrykal was carried out. The incidence of heart ruptures was reduced twofold in th is group as against the controls. Heart rupture risk factors in patien ts with myocardial infarction are described. The syndrome of excessive resorption in the prerupture period of myocardial infarction was sing led out, manifesting by increased activities of lactate dehydrogenase, lysosomal enzymes, and elevated level of cardiac antigen. Lysosomal e nzyme levels were measured in the myocardium in heart ruptures. The au thors have defined the notion of 'mechanical incompetence' in myocardi al infarction, consisting in inability of the involved myocardium to r esist the intraventricular blood pressure. The program of heart ruptur e prevention in myocardial infarction is presented.