The Pathogenesis of Spontaneous Cardiac Rupture

Twenty patients with cardiac rupture were compared with suitable control groups. In each ruptured heart there was an acute coronary artery occlusion and a recent, transmural myocardial infarction which was unprotected at the site of rupture by scar or anastomotic circulation. Clinically, rupture usually occurred during the first two weeks of an acute infarction in a hypertensive patient with no previous history of old infarction or congestive failure; persisting hypertension or excessive effort usually preceded rupture. The role of an increased intraventricular pressure in the pathogenesis of cardiac rupture has therapeutic implications.