MYOCARDIAL RUPTURE AFTER MYOCARDIAL-INFARCTION IS RELATED TO THE PERFUSION STATUS OF THE INFARCT-RELATED CORONARY-ARTERY

Acute or subacute myocardial rupture is a serious and often lethal com plication of acute myocardial infarction. The role of an occluded or o pen culprit coronary artery on the occurrence of this complication is not clear. We therefore reviewed the perfusion status of the infarct-r elated coronary artery retrospectively in 57 patients who had an initi ally nonfatal rupture (group A) and 28 patients (including 9 patients from group A) with a postmortem diagnosis of myocardial rupture (group a). In 35 of the 57 patients in group A, a coronary angiogram was ava ilable. Complete occlusion or ineffective reperfusion was present in 3 0 (89%) of 35 patients. The remaining 22 patients of group A showed no clinical signs of reperfusion. All 28 patients of group a had inadequ ate reperfusion of the infarcted area on postmortem angiography and ma croscopic examination of the coronary artery. Our observations suggest that myocardial rupture typically occurs in an infarcted area without reperfusion.