Document Detail

De subitaneis mortibus. XXIV. Ruptured interventricular septum and heart block.
MedLine Citation:
PMID:  870249     Owner:  NLM     Status:  MEDLINE    
Five patients with acute posterior myocardial infarction developed varying degrees of atrioventricular (A-V) block prior to rupture of their interventricular septums (IVS). In three of these five the times of septal rupture coincided with the resumption of conduced synus rhythm. During the period of A-V block, the only stable escape rhythm appeared to originate in the A-V junctional region, and in two patients early in their course there was evidence of enhanced A-V junctional automaticity. Although the A-V node contained extensive infarction in all five hearts, its distal part, and the entire His bundle and proximal branches appeared to be spared. The anatomical pattern of dissection within the ruptured IVS was similar in three hearts, extending upward to the crest of the IVS and penetrating into the interatrial septum in two of these. Multiple major coronary narrowing were present in all five hearts, especially of a dominating right coronary artery; recent thrombosis was present in the right coronary artery in four of the five cases. The A-V node artery was markedly narrowed by focal fibromuscular dysplasia in three hearts, compounding the ischemia for the A-V node and eliminating one important source of collateral circulation to the interventricular septum.
T N James
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  55     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1977 Jun 
Date Detail:
Created Date:  1977-06-30     Completed Date:  1977-06-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  934-46     Citation Subset:  AIM; IM    
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MeSH Terms
Atrioventricular Node / physiopathology
Bundle of His / physiopathology
Coronary Disease / complications,  pathology
Heart Block / etiology*,  pathology
Heart Diseases / etiology
Heart Septum* / pathology
Middle Aged
Myocardial Infarction / complications
Rupture, Spontaneous / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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