Document Detail


Postinfarction cardiac rupture despite immediate reperfusion therapy in a patient with severe aortic valve stenosis.
MedLine Citation:
PMID:  16440151     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 74-year-old woman with severe aortic valve stenosis (AS) was admitted to our hospital because of dyspnea on exertion. On day 2, she developed acute anterior wall myocardial infarction (MI) with ST elevation. Tissue plasminogen activator (tPA) was administered 10 min after the onset of chest pain, and emergency percutaneous coronary intervention was performed to induce coronary reperfusion after another 50 min. Five hours after MI onset, however, she suddenly went into electromechanical dissociation and died from cardiac rupture. This is the first case report of postinfarct cardiac rupture with severe AS occurring in spite of instituting immediate reperfusion therapy. High intraventricular pressure may be a critical risk factor for cardiac rupture in patients with AS complicated with acute MI. Further studies are required to clarify the risk and benefit of tPA administration before percutaneous coronary intervention and the necessity of the emergency correction of AS to prevent cardiac rupture.
Authors:
Makiko Tanaka; Yoichi Goto; Shoji Suzuki; Isao Morii; Yoritaka Otsuka; Shunichi Miyazaki; Hiroshi Nonogi
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart and vessels     Volume:  21     ISSN:  0910-8327     ISO Abbreviation:  Heart Vessels     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-27     Completed Date:  2007-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  59-62     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Aortic Valve Stenosis / complications*
Fatal Outcome
Female
Heart Rupture, Post-Infarction / etiology*,  therapy
Humans
Myocardial Reperfusion*

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


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