Acute and Cronic Complications After Acute Myocardial Infarction: A Watchful Waiting Strategy

Mechanical complications after acute myocardial infarction still have high mortality and morbidity rates despite advances in medical and surgical therapy. The gold standard of care is cardiac surgery although percutaneous strategies may be used in selected patient with contraindication and/or prohibitive surgical risk. However, in most cases cardiological management represents the best choice like a bridge to elective operation, the last associated with higher survival rates. We analysed the management of two cases of mechanical complication after acute myocardial infarction, that is subacute left ventricular free wall rupture (figure 1a, arrow) and pseudo–aneurysm after interventricular septum rupture (figure 2b, asterix). In both of them, we have demonstrated how the wait–and–see strategy associated with optimal cardiological management represents the successful therapy in this class of patients.