Skip to main content

Acute Complications of Myocardial Infarction

  • Chapter
  • First Online:
Echocardiography in Acute Coronary Syndrome

Acute myocardial infarction (AMI) affects 1.7 million people in the United States. Acute complications of AMI may occur within seconds to minutes after the acute event or up to a few days after it. Echocardiography is the goal standard imaging modality to identify these complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Otto C. The practice of clinical echocardiography. Chapter 12: Echocardiography in the Coronary Care Unit. Philadelphia, PA: WB Saunders Co.; 2002.

    Google Scholar 

  2. Purcaro A, Costantini C, Ciampani N, et al. Diagnostic criteria and management of subacute ventricular free wall rupture complicating acute myocardial infarction. Am J Cardiol. 1997;80:397.

    Article  PubMed  CAS  Google Scholar 

  3. Batts KP, Ackerman DM, Edwards WD. Postinfarction rupture of the left ventricular free wall: clinicopathologic correlates in 100 consecutive autopsy cases. Hum Pathol. 1990;21:530.

    Article  PubMed  CAS  Google Scholar 

  4. Reeder GS. Identification and treatment of complications of myocardial infarction. Mayo Clin Proc. 1995;70:880.

    Article  PubMed  CAS  Google Scholar 

  5. Pohjola-Sintonen S, Muller JE, Stone PH, et al. Ventricular septal and free wall rupture complicating acute myocardial infarction: experience in the Multicenter Investigation of Limitation of Infarct Size. Am Heart J. 1989;117:809.

    Article  PubMed  CAS  Google Scholar 

  6. Becker RC, Gore JM, Lambrew C, et al. for the National Registry of Myocardial Infarction Participants. A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction. J Am Coll Cardiol. 1996;27:1321.

    Article  PubMed  CAS  Google Scholar 

  7. Patel MR, Meine TJ, Lindblad L, et al. Cardiac tamponade in the fibrinolytic era: analysis of >100,000 patients with ST-segment elevation myocardial infarction. Am Heart J. 2006;151:316.

    Article  PubMed  Google Scholar 

  8. Becker RC, Hochman JS, Cannon CP, et al., for the TIMI 9 Investigators. Fatal cardiac rupture among patients treated with thrombolytic agents and adjunctive thrombin antagonists. Observations from the Thrombolysis and Thrombin Inhibition in Myocardial Infarction 9 study. J Am Coll Cardiol. 1999;33:479.

    Article  PubMed  Google Scholar 

  9. Moreno R, Lopez-Sendon J, Garcia E, et al. Primary angioplasty reduces the risk of left ventricular free wall rupture compared with thrombolysis in patients with acute myocardial infarction. J Am Coll Cardiol. 2002;39:598.

    Article  PubMed  Google Scholar 

  10. Pasternak RC, Braunwald E, Sobel BE. Acute myocardial infarction. In: Braunwald EB, ed. Heart Disease. 4th ed. Philadelphia, PA: Saunders; 1992:200.

    Google Scholar 

  11. Mechanisms for the early mortality reduction produced by beta-blockade started early in acute myocardial infarction: ISIS-1. ISIS-1 (First International Study of Infarct Survival) Collaborative Group. Lancet. 1988;1:921.

    Google Scholar 

  12. Batts KP, Ackerman DM, Edwards WD. Postinfarction rupture of the left ventricular free wall: clinicopathologic correlates in 100 consecutive autopsy cases. Hum Pathol. 1990;21:530.

    Article  PubMed  CAS  Google Scholar 

  13. Nakatsuchi Y, Minamino T, Fujii K, Negoro S. Clinicopathologic characterization of cardiac free wall rupture in patients with acute myocardial infarction: difference between early and late phase rupture. Int J Cardiol. 1994;47:S33.

    Article  PubMed  CAS  Google Scholar 

  14. Cheriex EC, de Swart H, Dijkman LW, et al. Myocardial rupture after myocardial infarction is related to the perfusion status of the infarct-related coronary artery. Am Heart J. 1995;129:644.

    Article  PubMed  CAS  Google Scholar 

  15. Honan MB, Harrell FE Jr, Reimer KA, et al. Cardiac rupture, mortality and the timing of thrombolytic therapy: a meta-analysis. J Am Coll Cardiol. 1990;16:359.

    Article  PubMed  CAS  Google Scholar 

  16. Gertz SD, Kragel AH, Kalan JM, et al. Comparison of coronary and myocardial morphologic findings in patients with and without thrombolytic therapy during fatal first acute myocardial infarction. The TIMI Investigators. Am J Cardiol. 1990;66:904.

    Article  PubMed  CAS  Google Scholar 

  17. Becker RC, Charlesworth A, Wilcox RG, et al. Cardiac rupture associated with thrombolytic therapy: impact of time to treatment in the late assessment of thrombolytic efficacy (LATE) study. J Am Coll Cardiol. 1995;25:1063.

    Article  PubMed  CAS  Google Scholar 

  18. Bueno H, Martinez-Selles M, Perez-David E, Lopez-Palop R. Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction. Eur Heart J. 2005;26:1705.

    Article  PubMed  CAS  Google Scholar 

  19. Nakatani D, Sato H, Kinjo K, et al. Effect of successful late reperfusion by primary coronary angioplasty on mechanical complications of acute myocardial infarction. Am J Cardiol. 2003;92:785.

    Article  PubMed  Google Scholar 

  20. McMullan MH, Maples MD, Kilgore TL Jr, Hindman SH. Surgical experience with left ventricular free wall rupture. Ann Thorac Surg. 2001;71:1894.

    Article  PubMed  CAS  Google Scholar 

  21. Lopez-Sendon J, Gonzalez A, Lopez de Sa E, et al. Diagnosis of subacute ventricular wall rupture after acute myocardial infarction: sensitivity and specificity of clinical, hemodynamic and echocardiographic criteria. J Am Coll Cardiol. 1992;19:1145–1153.

    Article  PubMed  CAS  Google Scholar 

  22. Feigenbaum H, Armstrong W, Ryan T. Feigenbaum’s Echocardiography. Chapter 15: Coronary Artery Disease. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.

    Google Scholar 

  23. Topaz O, Taylor AL. Interventricular septal rupture complicating acute myocardial infarction: from pathophysiologic features to the role of invasive and noninvasive diagnostic modalities in current management. Am J Med. 1992;93:683–688.

    Article  PubMed  CAS  Google Scholar 

  24. Crenshaw BS, Granger CB, Birnbaum Y, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation. 2000;101:27–32.

    PubMed  CAS  Google Scholar 

  25. Birnbaum Y, Fishbein MC, Blanche C, Siegel RJ. Ventricular septal rupture after acute myocardial infarction. N Engl J Med. 2002;347(18):1426–1432.

    Article  PubMed  Google Scholar 

  26. Davis N, Sistino JJ. Review of ventricular rupture: key concepts and diagnostic tools for success. Perfusion. 2002;17:63–67.

    Article  PubMed  Google Scholar 

  27. Buda AJ. The role of echocardiography in the evaluation of mechanical complications of acute myocardial infarction. Circulation. 1991;84(3 suppl):109–121.

    Google Scholar 

  28. Edwards BS, Edwards WD, Edwards JE. Ventricular septal rupture complicating acute myocardial infarction: identification of simple and complex types in 53 autopsied hearts. Am J Cardiol. 1984;54:1201–1205.

    Article  PubMed  CAS  Google Scholar 

  29. Cheriex EC, de Swart H, Dijkman LW, et al. Myocardial rupture after myocardial infarction is related to the perfusion status of the infarct-related artery. Am Heart J. 1995;129:644–650.

    Article  PubMed  CAS  Google Scholar 

  30. Sager RV. Coronary thrombosis; perforation of the infracted interventricular septum. Arch Intern Med. 1934;53:140–148.

    Article  Google Scholar 

  31. Fortin DF, Sheikh KH, Kisslo J. The utility of echocardiography in the diagnostic strategy of postinfarction ventricular septal rupture: a comparison of two-dimensional echocardiography versus Doppler color flow imaging. Am Heart J. 1991;121:25–32.

    Article  PubMed  CAS  Google Scholar 

  32. Helmcke F, Mahan EF, Nanda NC, et al. Two-dimensional echocardiographic and Doppler color flow mapping in the diagnosis and prognosis of ventricular septal rupture. Circulation. 1990;81(6):1775–1783.

    Article  PubMed  CAS  Google Scholar 

  33. Giuliani ER, Danielson GK, Pluth JR, Odyniec NA, Wallace RB. Postinfarction ventricular septal rupture: surgical considerations and results. Circulation. 1974;49:455–459.

    PubMed  CAS  Google Scholar 

  34. GUSTO Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993;329:1615–1622.

    Google Scholar 

  35. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341:625–634.

    Article  PubMed  CAS  Google Scholar 

  36. Menon V, Webb JG, Hillis LD, et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the SHOCK Trial Registry. J Am Coll Cardiol. 2000;36(suppl A):1110–1116.

    Article  PubMed  CAS  Google Scholar 

  37. Hochman JS, Jacobs ML, Sleeper LA, et al. Cardiogenic shock complicating acute myocardial infarction – etiologies, management and outcome: a report from the SHOCK Trial Registry. J Am Coll Cardiol. 2000;36(suppl A):1063–1070.

    Article  PubMed  CAS  Google Scholar 

  38. Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113:1622–1632.

    Article  PubMed  Google Scholar 

  39. Maisch E, Seferovic PM, Ristic AD, et al. for the Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases: executive summary. Eur Heart J. 2004;25: 587–610.

    Article  PubMed  Google Scholar 

  40. Hoit BD. Pericardial disease and pericardial tamponade. Crit Care Med. 2007;35(8 suppl):S355–S364.

    Article  PubMed  Google Scholar 

  41. Shabetai R. The pericardium: an essay on some recent developments. Am J Cardiol. 1978;263:H1657–H1681.

    Google Scholar 

  42. Miyazaki T, Pride HP, Zipes DP. Prostaglandins in the pericardial fluid modulate neural regulation of cardiac electrophysiological properties. Circulation Res. 1990;66:163–175.

    PubMed  CAS  Google Scholar 

  43. LeWinter MM, Kabbani S. Pericardial diseases. In: Zipes DP, Libby P, Monow RO, Braunwald E, eds. Braunwald’s Heart Disease. 7th ed. Philadelphia, PA: Elsevier Saunders; 2005:1757–1780.

    Google Scholar 

  44. Maisch B. Pericardial diseases, with a focus on etiology, pathogenesis, pathophysiology, new diagnostic imaging methods, and treatment. Curr Opin Cardiol. 1994;9:379–388.

    Article  PubMed  CAS  Google Scholar 

  45. Weitzman LB, Tinker WP, Kronzon I, et al. The incidence and natural history of pericardial effusion after cardiac surgery: an echocardiographic study. Circulation. 1984;69:506–511.

    Article  PubMed  CAS  Google Scholar 

  46. Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684–690.

    Article  PubMed  Google Scholar 

  47. Roy LR, Minor MA, Brookhart MA, Choudhry NK. Does this patient with a pericardial effusion have cardiac tamponade? J Am Med Assoc. 2007;297(16):1810–1818.

    Article  CAS  Google Scholar 

  48. Beck C. Two cardiac compression triads. J Am Med Assoc. 1935;104:714–716.

    Article  Google Scholar 

  49. Kussmaul A. Uber schwielige Mediastinoperikarditis und den paradoxen. Puls Berl Klin Wochenschr. 1873;10:433–435.

    Google Scholar 

  50. Curtiss El, Reddy PS, Uretsky BF, Cecchetti AA. Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J. 1988;115:391–398.

    Article  PubMed  CAS  Google Scholar 

  51. Knopf WD, Talley JD, Murphy DA. An echo-dense mass in the pericardial space as a sign of left ventricular free wall rupture during acute myocardial infarction. Am J Cardiol. 1987;59:1202.

    Article  PubMed  CAS  Google Scholar 

  52. Faigenbaum H, Armsrtong WF, Ryan T. Pericardial Diseases in Faigenbaum’s Echocardiography. 6th ed. Philadelphia, PA: Lippincott Willams and Wilkins; 2005:247–270.

    Google Scholar 

  53. Tsang TS, Enriquez-Sarano M, Freeman WK, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77:429–436.

    PubMed  Google Scholar 

  54. Tsang TS, Barnes ME, Hayes SN, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management. Mayo Clin Exp. 1979–1988. Chest. 1999;116:322–331.

    CAS  Google Scholar 

  55. Kinch JW, Ryan TJ. Right ventricular infarction. N Engl J Med. 1994;330:1211–1219.

    Article  PubMed  CAS  Google Scholar 

  56. Haji SA, Movahed A. Right ventricular infarction – diagnosis and treatment. Clin Cardiol. 2000;23:473–482.

    Article  PubMed  CAS  Google Scholar 

  57. Lee FA. Hemodynamics of the right ventricle in normal and disease states. Clin Cardiol. 1992;10:59–67.

    CAS  Google Scholar 

  58. Anderson HR, Falk E, Nielsen D. Right ventricular infarction: frequency, size and topography in coronary heart disease: a prospective study comprising 107 consecutive autopsies from a coronary care unit. J Am Coll Cardiol. 1987;10:1223–1232.

    Article  Google Scholar 

  59. Horan LG, Flowers NC. Right ventricular infarction: specific requirements of management. Am Fam Physician. 1999;60(6):1727–1734.

    PubMed  CAS  Google Scholar 

  60. Goldstein JA, Barzilai B, Rosamond TL, Eisenberg PR, Jaffe AS. Determinants of hemodynamic compromise with severe right ventricular infarction. Circulation. 1990;82:359–368.

    Article  PubMed  CAS  Google Scholar 

  61. Dell’Italia LJ, Starling MR, O’Rourke RA. Physical examination for exclusion of hemodynamically important right ventricular infarction. Ann Intern Med. 1983;99:608–611.

    PubMed  Google Scholar 

  62. Cintron GB, Hernandez E, Linares E, Aranda JM. Bedside recognition, incidence and clinical course of right ventricular infarction. Am J Cardiol. 1981;47:224–227.

    Article  PubMed  CAS  Google Scholar 

  63. Zehender M, Kasper W, Kauder E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med. 1993;328:981–988.

    Article  PubMed  CAS  Google Scholar 

  64. Bellamy GR, Rasmussen HH, Nasser FN, Wiseman JC, Cooper RA. Value of two-dimensional echocardiography, electrocardiography, and clinical signs in detecting right ventricular infarction. Am Heart J. 1986;112:304–309.

    Article  PubMed  CAS  Google Scholar 

  65. Moller JE, Sondergaard E, Poulsen SH, et al. Serial Doppler echocardiographic assessment of left and right ventricular performance after a first myocardial infarction. J Am Soc Echocardiogr. 2001;14:249–255.

    Article  PubMed  CAS  Google Scholar 

  66. Cohen A, Logeart D, Costagliola D, et al. Usefulness of pulmonary regurgitation Doppler tracings in predicting in-hospital and long term outcome in patients with inferior wall acute myocardial infarction. Am J Cardiol. 1998;81:276–281.

    Article  PubMed  CAS  Google Scholar 

  67. Braat SH, deZwann C, Brugada P, Coenegracht JM, Wellens HJJ. Right ventricular involvement with acute inferior wall myocardial infarction identifies high risk of developing atrioventricular nodal conduction disturbances. Am Heart J. 1984;107:1183–1187.

    Article  PubMed  CAS  Google Scholar 

  68. Love JC, Haffajee CI, Gore JM, Alpert JS. Reversibility of hypotension and shock by atrial or atrioventricular sequential pacing in patients with right ventricular infarction. Am Heart J. 1984;108:5–13.

    Article  PubMed  CAS  Google Scholar 

  69. Berger PB, Ruocco NA Jr, Ryan TJ, et al. Frequency and significance of right ventricular dysfunction during inferior wall left ventricular myocardial infarction treated with thrombolytic therapy (results from the Thrombolysis in Myocardial Infarction. [TIMI] II trial. Am J Cardiol. 1993;71:1148–1152.

    Article  PubMed  CAS  Google Scholar 

  70. Moreyra AE, Suh C, Porway MN, Costis JB. Rapid hemodynamic improvement in right ventricular infarction after coronary angioplasty. Chest. 1988;94:197–199.

    Article  PubMed  CAS  Google Scholar 

  71. Bowers TR, O’Neil WW, Grines C, Pica MC, Safian RD, Goldstein JA. Effect of reperfusion on biventricular function and survival after right ventricular infarction. N Engl J Med. 1998;338:933–942.

    Article  PubMed  CAS  Google Scholar 

  72. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341:625–634.

    Article  PubMed  CAS  Google Scholar 

  73. Jacobs AK, Leopold JA, Bates E, et al. Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. J Am Coll Cardiol. 2003;41:1273–1279.

    Article  PubMed  Google Scholar 

  74. Tcheng JE, Jackman JD, Nelson CL, et al. Outcome of patients sustaining acute ischemic mitral regurgitation during myocardial infarction. Ann Intern Med. 1992;117:18.

    PubMed  CAS  Google Scholar 

  75. Lavie CJ, Gersh BJ. Mechanical and electrical complications of acute myocardial infarction. Mayo Clin Proc. 1990;65:709.

    PubMed  CAS  Google Scholar 

  76. Feigenbaum H, Armstrong W, Ryan T. Feigenbaum’s Echocardiography. Chapter 11: Mitral Valve Disease. 6th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.

    Google Scholar 

  77. Reeder GS. Identification and treatment of complications of myocardial infarction. Mayo Clin Proc. 1995;70:880.

    Article  PubMed  CAS  Google Scholar 

  78. Hochman JS, Jacobs ML, Sleeper LA, et al. Cardiogenic shock complicating acute myocardial infarction – etiologies, management and outcome: a report from the SHOCK Trial Registry. J Am Coll Cardiol. 2000;36(suppl A):1063–1070.

    Article  PubMed  CAS  Google Scholar 

  79. Picard MH, Davidoff R, Sleeper LA, et al. Echocardiographic predictors of survival and response to early revascularization in cardiogenic shock. Circulation. 2003;107:279.

    Article  PubMed  Google Scholar 

  80. David TE. Techniques and results of mitral valve repair for ischemic mitral regurgitation. J Card Surg. 1994;9:274.

    Article  PubMed  CAS  Google Scholar 

  81. Himmelman RB, Kusumoto F, Oken K, et al. The flail mitral valve: echocardiographic findings by precordial and trans-esophageal imaging and Doppler color flow mapping. J Am Coll Cardiol. 1991;17:272–279.

    Article  Google Scholar 

  82. Enriquez-Sarano M, Freeman WK, Tribouilloy CM, et al. Functional anatomy of mitral regurgitation: accuracy and outcome implication of transesophageal echocardiography. J Am Coll Cardiol. 1999;34:129–1136.

    Google Scholar 

  83. Sochowski RA, Chan KL, Ascah KJ, Bedard P. Comparison of accuracy of transesophageal versus transthoracic echocardiography for the detection of mitral valve prolapse with ruptured chordae tendinae (flail mitral leaflet). Am J Cardiol. 1991;67:1251–1255.

    Article  PubMed  CAS  Google Scholar 

  84. Moursi MH, Bhatnagar SK, Vilacosta I, et al. Transesophageal echocardiographic assessment of papillary muscle rupture. Circulation. 1996;94:1003.

    PubMed  CAS  Google Scholar 

  85. Colombo PC, Wu RH, Weiner S, et al. Value of quantitative analysis of mitral regurgitation jet eccentricity by color flow Doppler for identification of flail leaflet. Am J Cardiol. 2001;88:534–540.

    Article  PubMed  CAS  Google Scholar 

  86. Kishon Y, Oh JK, Schaff HV, et al. Mitral valve operation in postinfarction rupture of a papillary muscle: immediate results and long-term follow-up of 22 patients. Mayo Clin Proc. 1992;67:1023.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gregory Janis .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag London Limited

About this chapter

Cite this chapter

Janis, G., Khianey, S., Joshi, S., Herzog, E. (2009). Acute Complications of Myocardial Infarction. In: Herzog, E., Chaudhry, F. (eds) Echocardiography in Acute Coronary Syndrome. Springer, London. https://doi.org/10.1007/978-1-84882-027-2_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-027-2_20

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-026-5

  • Online ISBN: 978-1-84882-027-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics