Myocardial rupture as a cause of sudden cardiac death following STEMI
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Myocardial rupture Microchapters |
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Relative Contribution of Myocardial Rupture as a Cause of Sudden Cardiac Death Following STEMI |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Relative Contribution of Myocardial Rupture, Cardiac Arrest and Recurrent MI as a Cause of Sudden Death Following STEMI
Despite implantation of AICDs, there remains a high incidence of sudden death following ST elevation MI. This is due to the fact that not all sudden death is due to arrythmias in the period following ST elevation MI. Based upon autopsy findings, the relative frequency of various pathophysiologic events among 105 cases was as follows[1]:
- 3 Index MIs in the first 7 days (2.9%)
- 28 Recurrent MIs (26.6%)
- 13 Cardiac ruptures (12.4%)
- 4 Pump failures (3.8%)
- 2 Other cardiovascular causes (stroke or pulmonary embolism; 1.9%)
- 1 Noncardiovascular cause (1%)
- 54 cases (51.4%) had no acute specific autopsy evidence other than the index MI and were thus presumed arrhythmic.
The relative contribution of arrhythmic death was lowest in the first month, while the relative contribution of recurrent MI or cardiac rupture was highest in the first month following ST elevation MI. After three months, however, the relative contribution shifted so that the proportion of cases attributable to arrhythmias was significantly higher than recurrent MI or rupture (P<0.0001).
References
- ↑ Pouleur AC, Barkoudah E, Uno H, Skali H, Finn PV, Zelenkofske SL, Belenkov YN, Mareev V, Velazquez EJ, Rouleau JL, Maggioni AP, Køber L, Califf RM, McMurray JJ, Pfeffer MA, Solomon SD (2010). "Pathogenesis of Sudden Unexpected Death in a Clinical Trial of Patients With Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both". Circulation. doi:10.1161/CIRCULATIONAHA.110.940619. PMID 20660803. Retrieved 2010-08-10. Unknown parameter
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