Myocardial Rupture and Hemopericardium Associated with Anticoagulant Therapy

A DISTURBING feature of the occasional case of fatal hemopericardium following anticoagulant therapy for myocardial infarction is the absence of an obvious explanation for the hemorrhage. Heretofore, a pericardium distended with blood in a patient with myocardial infarction has usually been the result of a ruptured myocardium. However, Hammarsten1 reported in 1949 a case with massive hemopericardium that followed Dicumarol treatment in which low levels of prothrombin activity (10 per cent or less) were obtained; 800 cc. of blood was found in the pericardium and yet no rupture of the heart or a vessel could be demonstrated. Nichol,2 Goldstein and . . .