[Myocardial infarct and rupture of the left ventricular free wall. Some considerations on incidence, morphological characteristics and risk factors].

: Rupture of the left ventricle free wall is a sudden and unexpected event in myocardial infarction. It is considered the third most common cause of death, following cardiogenic shock and arrhythmias. The frequency of rupture varies because many patients may survive the initial insult of myocardial infarction. Conflicting reports regarding risk factors have been published by several authors. With these considerations in mind, the present investigation was undertaken to evaluate ventricular rupture in an autopsy population from the Instituto Nacional de Cardiologia. We analyzed the salient morphologic features and the risk factors. Our results indicated an incidence rate of 17.7% of cardiac rupture in patients who died of acute myocardial infarction and were autopsied. Ruptures are more common in elderly female patient during their first infarct, they were localized preferentially in the anterior wall and occurred within the first four days after infarction. Chance of rupture was greater in hypertensive patients, whereas a history of previous infarct protected against this contingency.