Highlights the epidemiological context and timing of external cardiac rupture as a fatal complication of myocardial infarction.
Alerts clinicians to subacute MI rupture risk; leaves open whether contemporary reperfusion alters incidence or prevention.
Rupture of the heart was first described by Harvey in 1647.¹Of all the deaths attributed to myocardial infarction 8 to 12 per cent²are said to be due to rupture of the myocardium. This complication usually occurs between the second and twelfth day and seldom occurs during the first twentyfour hours.2bThe average age of death in a series of 10 cases reported by Friedman and White2awas 65.7 years of age. Rupture of the heart is about four times as frequent in the presence of hypertension as in the presence of normal blood pressure.³The value of bed rest in preventing myocardial rupture during infarction is emphasized by the study of White and Jetter⁴in mental patients. Seventy-three per cent of the deaths due to infarction were caused by rupture, and in the majority an antemortem diagnosis was not made. The appearance
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LINTON BISHOP (1950) studied this question.
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